Atlas-Based Segmentation in Extraction of Knee Joint Bone Structures from CT and MR

The main goal of the approach proposed in this study, which is dedicated to the extraction of bone structures of the knee joint (femoral head, tibia, and patella), was to show a fully automated method of extracting these structures based on atlas segmentation. In order to realize the above-mentioned goal, an algorithm employed automated image-matching as the first step, followed by the normalization of clinical images and the determination of the 11-element dataset to which all scans in the series were allocated. This allowed for a delineation of the average feature vector for the teaching group in the next step, which automated and streamlined known fuzzy segmentation methods (fuzzy c-means (FCM), fuzzy connectedness (FC)). These averaged features were then transmitted to the FCM and FC methods, which were implemented for the testing group and correspondingly for each scan. In this approach, two features are important: the centroids (which become starting points for the fuzzy methods) and the surface area of the extracted bone structure (protects against over-segmentation). This proposed approach was implemented in MATLAB and tested in 61 clinical CT studies of the lower limb on the transverse plane and in 107 T1-weighted MRI studies of the knee joint on the sagittal plane. The atlas-based segmentation combined with the fuzzy methods achieved a Dice index of 85.52-89.48% for the bone structures of the knee joint.