A fully automated knee MRI segmentation method to study osteoarthritis (OA)
was developed using a novel hierarchical set of random forests (RF) classifiers
to learn the appearance of cartilage regions and their boundaries. A
neighborhood approximation forest is used first to provide contextual feature
to the second-level RF classifier that also considers local features and
produces location-specific costs for the layered optimal graph image
segmentation of multiple objects and surfaces (LOGISMOS) framework. Double echo
steady state (DESS) MRIs used in this work originated from the Osteoarthritis
Initiative (OAI) study. Trained on 34 MRIs with varying degrees of OA, the
performance of the learning-based method tested on 108 MRIs showed a
significant reduction in segmentation errors (\emph{p}<0.05) compared with
the conventional gradient-based and single-stage RF-learned costs. The 3D
LOGISMOS was extended to longitudinal-3D (4D) to simultaneously segment
multiple follow-up visits of the same patient. As such, data from all
time-points of the temporal sequence contribute information to a single optimal
solution that utilizes both spatial 3D and temporal contexts. 4D LOGISMOS
validation on 108 MRIs from baseline and 12 month follow-up scans of 54
patients showed a significant reduction in segmentation errors
(\emph{p}<0.01) compared to 3D. Finally, the potential of 4D LOGISMOS was
further explored on the same 54 patients using 5 annual follow-up scans
demonstrating a significant improvement of measuring cartilage thickness
(\emph{p}<0.01) compared to the sequential 3D approach.Comment: IEEE Transactions in Medical Imaging, 11 page