Compression fracture diagnosis in lumbar: a clinical CAD system.

PURPOSE: Lower back pain affects 80-90 % of all people at some point during their life time, and it is considered as the second most neurological ailment after headache. It is caused by defects in the discs, vertebrae, or the soft tissues. Radiologists perform diagnosis mainly from X-ray radiographs, MRI, or CT depending on the target organ. Vertebra fracture is usually diagnosed from X-ray radiographs or CT depending on the available technology. In this paper, we propose a fully automated Computer-Aided Diagnosis System (CAD) for the diagnosis of vertebra wedge compression fracture from CT images that integrates within the clinical routine. METHODS: We perform vertebrae localization and labeling, segment the vertebrae, and then diagnose each vertebra. We perform labeling and segmentation via coordinated system that consists of an Active Shape Model and a Gradient Vector Flow Active Contours (GVF-Snake). We propose a set of clinically motivated features that distinguish the fractured vertebra. We provide two machine learning solutions that utilize our features including a supervised learner (Neural Networks (NN)) and an unsupervised learner (K-Means). RESULTS: We validate our method on a set of fifty (thirty abnormal) Computed Tomography (CT) cases obtained from our collaborating radiology center. Our diagnosis detection accuracy using NN is 93.2 % on average while we obtained 98 % diagnosis accuracy using K-Means. Our K-Means resulted in a specificity of 87.5 % and sensitivity over 99 %. CONCLUSIONS: We presented a fully automated CAD system that seamlessly integrates within the clinical work flow of the radiologist. Our clinically motivated features resulted in a great performance of both the supervised and unsupervised learners that we utilize to validate our CAD system. Our CAD system results are promising to serve in clinical applications after extensive validation.

Segmentation of lumbar vertebrae from clinical CT using active shape models and GVF-snake.

Lumbar area of the vertebral column bears the most load of the human body and thus it is responsible for the major portion of lower back pain from which 80% to 90% of people suffer from during their lifetime. Vertebra related diseases are mainly fracture and are usually diagnosed from X-ray radiographs or CT scans depending on the severity of the problem. In this paper, we propose a fully automated lumbar vertebra segmentation that accurately and robustly produces a smooth contour around each of the vertebrae. This segmentation is very useful in any subsequent CAD system for diagnosis and quantification of vertebrae fractures. It also serves the radiologist during the clinical routine. Our method shows an excellent level of vertebra boundary smootheness that was visually approved by our collaborating radiologist for each vertebra and each case from our fifty cases dataset that includes both normal and abnormal cases.