Automated landmarking and labeling of fully and partially scanned spinal columns in CT images

The spinal column is one of the most distinguishable structures in CT scans of the superior part of the human body. It is not necessary to segment the spinal column in order to use it as a frame of reference. It is sufficient to place landmarks and the appropriate anatomical labels at intervertebral disks and vertebrae. In this paper, we present an automated system for landmarking and labeling spinal columns in 3D CT datasets. We designed this framework with two goals in mind. First, we relaxed input data requirements found in the literature, and we label both full and partial spine scans. Secondly, we intended to fulfill the performance requirement for daily clinical use and developed a high throughput system capable of processing thousands of slices in just a few minutes. To accomplish the aforementioned goals, we encoded structural knowledge from training data in probabilistic boosting trees and used it to detect efficiently the spinal canal, intervertebral disks, and three reference regions responsible for initializing the landmarking and labeling. Final landmarks and labels are selected by Markov Random Field-based matches of newly introduced 3-disk models. The framework has been tested on 36 CT images having at least one of the regions around the thoracic first ribs, the thoracic twelfth ribs, or the sacrum. In an average time of 2 min, we achieved a correct labeling in 35 cases with precision of 99.0% and recall of 97.2%. Additionally, we present results assuming none of the three reference regions could be detected.