Lumbar spine MRI annotation with intervertebral disc height and Pfirrmann grade predictions.

Many lumbar spine diseases are caused by defects or degeneration of lumbar intervertebral discs (IVD) and are usually diagnosed through inspection of the patient's lumbar spine MRI. Efficient and accurate assessments of the lumbar spine are essential but a challenge due to the size of the clinical radiologist workforce not keeping pace with the demand for radiology services. In this paper, we present a methodology to automatically annotate lumbar spine IVDs with their height and degenerative state which is quantified using the Pfirrmann grading system. The method starts with semantic segmentation of a mid-sagittal MRI image into six distinct non-overlapping regions, including the IVD and vertebrae regions. Each IVD region is then located and assigned with its label. Using geometry, a line segment bisecting the IVD is determined and its Euclidean distance is used as the IVD height. We then extract an image feature, called self-similar color correlogram, from the nucleus of the IVD region as a representation of the region's spatial pixel intensity distribution. We then use the IVD height data and machine learning classification process to predict the Pfirrmann grade of the IVD. We considered five different deep learning networks and six different machine learning algorithms in our experiment and found the ResNet-50 model and Ensemble of Decision Trees classifier to be the combination that gives the best results. When tested using a dataset containing 515 MRI studies, we achieved a mean accuracy of 88.1%.

Automated selection of mid-height intervertebral disc slice in traverse lumbar spine MRI using a combination of deep learning feature and machine learning classifier.

Abnormalities and defects that can cause lumbar spinal stenosis often occur in the Intervertebral Disc (IVD) of the patient's lumbar spine. Their automatic detection and classification require an application of an image analysis algorithm on suitable images, such as mid-sagittal images or traverse mid-height intervertebral disc slices, as inputs. Hence the process of selecting and separating these images from other medical images in the patient's set of scans is necessary. However, the technological progress in making this process automated is still lagging behind other areas in medical image classification research. In this paper, we report the result of our investigation on the suitability and performance of different approaches of machine learning to automatically select the best traverse plane that cuts closest to the half-height of an IVD from a database of lumbar spine MRI images. This study considers images features extracted using eleven different pre-trained Deep Convolution Neural Network (DCNN) models. We investigate the effectiveness of three dimensionality-reduction techniques and three feature-selection techniques on the classification performance. We also investigate the performance of five different Machine Learning (ML) algorithms and three Fully Connected (FC) neural network learning optimizers which are used to train an image classifier with hyperparameter optimization using a wide range of hyperparameter options and values. The different combinations of methods are tested on a publicly available lumbar spine MRI dataset consisting of MRI studies of 515 patients with symptomatic back pain. Our experiment shows that applying the Support Vector Machine algorithm with a short Gaussian kernel on full-length image features extracted using a pre-trained DenseNet201 model is the best approach to use. This approach gives the minimum per-class classification performance of around 0.88 when measured using the precision and recall metrics. The median performance measured using the precision metric ranges from 0.95 to 0.99 whereas that using the recall metric ranges from 0.93 to 1.0. When only considering the L3/L4, L4/L5, and L5/S1 classes, the minimum F1-Scores range between 0.93 to 0.95, whereas the median F1-Scores range between 0.97 to 0.99.

Automated measurement of anteroposterior diameter and foraminal widths in MRI images for lumbar spinal stenosis diagnosis.

Lumbar Spinal Stenosis causes low back pain through pressures exerted on the spinal nerves. This can be verified by measuring the anteroposterior diameter and foraminal widths of the patient's lumbar spine. Our goal is to develop a novel strategy for assessing the extent of Lumbar Spinal Stenosis by automatically calculating these distances from the patient's lumbar spine MRI. Our method starts with a semantic segmentation of T1- and T2-weighted composite axial MRI images using SegNet that partitions the image into six regions of interest. They consist of three main regions-of-interest, namely the Intervertebral Disc, Posterior Element, and Thecal Sac, and three auxiliary regions-of-interest that includes the Area between Anterior and Posterior elements. A novel contour evolution algorithm is then applied to improve the accuracy of the segmentation results along important region boundaries. Nine anatomical landmarks on the image are located by delineating the region boundaries found in the segmented image before the anteroposterior diameter and foraminal widths can be measured. The performance of the proposed algorithm was evaluated through a set of experiments on the Lumbar Spine MRI dataset containing MRI studies of 515 patients. These experiments compare the performance of our contour evolution algorithm with the Geodesic Active Contour and Chan-Vese methods over 22 different setups. We found that our method works best when our contour evolution algorithm is applied to improve the accuracy of both the label images used to train the SegNet model and the automatically segmented image. The average error of the calculated right and left foraminal distances relative to their expert-measured distances are 0.28 mm (p = 0.92) and 0.29 mm (p = 0.97), respectively. The average error of the calculated anteroposterior diameter relative to their expert-measured diameter is 0.90 mm (p = 0.92). The method also achieves 96.7% agreement with an expert opinion on determining the severity of the Intervertebral Disc herniations.