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This paper proposes an automatic method for scapula bone segmentation from Magnetic Resonance (MR) images using deep learning. The purpose of this work is to incorporate anatomical priors into a conditional adversarial framework, given a limited amount of heterogeneous annotated images. Our approach encourages the segmentation model to follow the global anatomical properties of the underlying anatomy through a learnt non-linear shape representation while the adversarial contribution refines the model by promoting realistic delineations. These contributions are evaluated on a data set of 15 pediatric shoulder examinations, and compared to stateof-the-art architectures including UNet and recent derivatives. The significant improvements achieved bring new perspectives for the pre-operative management of musculo-skeletal diseases.

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Automatic segmentation of the musculoskeletal system in pediatric magnetic resonance (MR) images is a challenging but crucial task for morphological evaluation in clinical practice. We propose a deep learning-based regularized segmentation method for multi-structure bone delineation in MR images, designed to overcome the inherent scarcity and heterogeneity of pediatric data. Based on a newly devised shape code discriminator, our adversarial regularization scheme enforces the deep network to follow a learnt shape representation of the anatomy. The novel shape priors based adversarial regularization (SPAR) exploits latent shape codes arising from ground truth and predicted masks to guide the segmentation network towards more consistent and plausible predictions. Our contribution is compared to state-of-the-art regularization methods on two pediatric musculoskeletal imaging datasets from ankle and shoulder joints.