Int J Comput Assist Radiol Surg - Statistical model-based segmentation of the proximal femur in digital antero-posterior (AP) pelvic radiographs.


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RPOSE: Segmentation of the proximal femur in digital antero-posterior (AP) pelvic radiographs is required to create a three-dimensional model of the hip joint for use in planning and treatment. However, manually extracting the femoral contour is tedious and prone to subjective bias, while automatic segmentation must accommodate poor image quality, anatomical structure overlap, and femur deformity. A new method was developed for femur segmentation in AP pelvic radiographs.METHODS: Using manual annotations on 100 AP pelvic radiographs, a statistical shape model (SSM) and a statistical appearance model (SAM) of the femur contour were constructed. The SSM and SAM were used to segment new AP pelvic radiographs with a three-stage approach. At initialization, the mean SSM model is coarsely registered to the femur in the AP radiograph through a scaled rigid registration. Mahalanobis distance defined on the SAM is employed as the search criteria for each annotated suggested landmark location. Dynamic programming was used to eliminate ambiguities. After all landmarks are assigned, a regularized non-rigid registration method deforms the current mean shape of SSM to produce a new segmentation of proximal femur. The second and third stages are iteratively executed to convergence.RESULTS: A set of 100 clinical AP pelvic radiographs (not used for training) were evaluated. The mean segmentation error was 0.96 mm ? 0.35 mm, requiring <5 s per case when implemented with Matlab. The influence of the initialization on segmentation results was tested by six clinicians, demonstrating no significance difference.CONCLUSIONS: A fast, robust and accurate method for femur segmentation in digital AP pelvic radiographs was developed by combining SSM and SAM with dynamic programming. This method can be extended to segmentation of other bony structures such as the pelvis.

Resumo Limpo

rpose segment proxim femur digit anteroposterior ap pelvic radiograph requir creat threedimension model hip joint use plan treatment howev manual extract femor contour tedious prone subject bias automat segment must accommod poor imag qualiti anatom structur overlap femur deform new method develop femur segment ap pelvic radiographsmethod use manual annot ap pelvic radiograph statist shape model ssm statist appear model sam femur contour construct ssm sam use segment new ap pelvic radiograph threestag approach initi mean ssm model coars regist femur ap radiograph scale rigid registr mahalanobi distanc defin sam employ search criteria annot suggest landmark locat dynam program use elimin ambigu landmark assign regular nonrigid registr method deform current mean shape ssm produc new segment proxim femur second third stage iter execut convergenceresult set clinic ap pelvic radiograph use train evalu mean segment error mm mm requir s per case implement matlab influenc initi segment result test six clinician demonstr signific differenceconclus fast robust accur method femur segment digit ap pelvic radiograph develop combin ssm sam dynam program method can extend segment boni structur pelvi

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