Automated segmentation of trabecular and cortical bone from proton density weighted MRI of the knee

Patient-specific implant design and pre- and intra-operative planning is becoming increasingly important in the orthopaedic field. For clinical feasibility of these techniques, fast and accurate segmentation of bone structures from MRI is essential. However, manual segmentation is time intensive and subject to inter- and intra-observer variation. The challenge in developing automatic segmentation algorithms for MRI data mainly exists in the inhomogeneity problem and the low contrast among cortical bone and adjacent tissues. In this paper, we proposed a method for automatic segmentation of knee bone structures for MRI data with a 3D local intensity clustering-based level set and a novel approach to determine the cortical boundary utilizing the normal vector of the trabecular surface. Application to clinical imaging data shows that our method is robust to MRI inhomogeneity. In comparing our method to manual segmentation in 18 femurs and tibiae, we found a dice similarity coefficient (DSC) of 0.9611 ± 0.0052 for the femurs and 0.9591 ± 0.0173 for tibiae. The average surface distance error was 0.4649 ± 0.1430 mm for the femurs and 0.4712 ± 0.2113 mm for the tibiae. The results of the automatic technique thus strongly corresponded to the manual segmentation using less than 3% of the time and with virtually no workload. Graphical abstract ᅟ.