A fully automatic method generating a whole body atlas from CT images is presented. The atlas serves as a reference space for annotations. It is based on a large collection of partially overlapping medical images and a registration scheme. The atlas itself consists of probabilistic tissue type maps and can represent anatomical variations. The registration scheme is based on an entropy-like measure of these maps and is robust with respect to field-of-view variations. In contrast to other atlas generation methods, which typically rely on a sufficiently large set of annotations on training cases, the presented method requires only the images. An iterative refinemen t strategy is used to automatically stitch the images to build the atlas.Affine registration of unseen CT images to the probabilistic atlas can be used to transfer reference annotations, e.g. organ models for segmentation initialization or reference bounding boxes for field-of-view selection. The robustness and generality of the method is shown using a three-fold cross-validation of the registration on a set of 316 CT images of unknown content and large anatomical variability. As an example, 17 organs are annotated in the atlas reference space and their localization in the test images is evaluated. The method yields a recall (sensitivity), specificity and precision of at least 96% and thus performs excellent in comparison to competitors.
DESCRIPTION OF PURPOSEThe correlation of an unknown image to human anatomy is an important task in many medical image processing applications, 1-3 e.g. for automatic organ segmentation, which has applications in radiotherapy planning, surgery planning and other clinical tasks. Other applications are workflow simplification by detection of image content and automation of subsequent processing steps or large scale data analysis by retrieving certain anatomical regions from image databases.Two approaches to anatomy correlation can be distinguished: structure detection and registration to a reference space. A recent detection approach for organs has been published by Criminisi et al. 4 , where trained regression forests are used for bounding box detection. The application to an unseen image is fast, robust, and organ localization accuracy outperforms standard registration-based methods. A prerequisite is the definition of tight organ bounding boxes in all training data sets. The detection result is then also a bounding box.While the detection of individual structures must typically be re-trained for new organs, registration to a reference space can be used to detect the field-of-view and estimate the locations of several organs simultaneously. Multi-atlas approaches 5 are able to handle a variety of images via a database of reference images which are all registered to an unknown image independently. These approaches suffer from long computation times and a strong dependency on the selection of example images in the atlas. In contrast, atlases with a single reference image have difficulties to deal with local variability.In r...