Deep learning for automatic segmentation of paraspinal muscle on computed tomography

Abstract

Background Muscle quantification is an essential step in sarcopenia evaluation. Purpose To develop and evaluate an automated machine learning (ML) algorithm for segmenting the paraspinous muscles on either abdominal or lumbar (L) computed tomography (CT) scans. Material and Methods A novel deep neural network algorithm for automated segmentation of paraspinous muscle was developed, CT scans of 504 consecutive patients conducted between January 2019 and February 2020 were assembled. The muscle was manually segmented at L3 vertebra level by three radiologists as ground truth, divided into training and testing subgroups. Muscle cross-sectional area (CSA) was recorded. Dice similarity coefficients (DSCs) and CSA errors were calculated to evaluate system performance. The degree of muscle fat infiltration (MFI) recording by percentage value was the fat area within the region of interest divided by the muscle area. An analysis of the factors influencing the performance of the V-net-based segmentation system was also implemented. Results The mean DSCs for paraspinous muscles were high for both the training (0.963, 0.970, 0.941, and 0.968, respectively) and testing (0.950, 0.960, 0.929, and 0.961, respectively) datasets, while the CSA errors were low for both training (1.9%, 1.6%, 3.1%, and 1.3%, respectively) and testing (3.4%, 3.0%, 4.6%, and 1.9%, respectively) datasets. MFI and muscle area index (MI) were major factors affecting DSCs of the posterior paraspinous and paraspinous muscle groups. Conclusion The ML algorithm for the measurement of paraspinous muscles was compared favorably to manual ground truth measurements.

Percentiles for paraspinal muscle parameters at the L3 vertebra level in patients undergoing lumbar computed tomography scanning

“…2, with the muscle being analyzed having been delineated. Using this DL system, the Dice similarity coefficient (DSC) values for training and testing cohorts were 0.96 and 0.95, respectively, consistent with good system performance (21). This automated DL system enables analyses of muscle bulk and muscle fat infiltration (MFI) at a target segmentation level.…”

“…2, with the muscle being analyzed having been delineated. Using this DL system, the Dice similarity coefficient (DSC) values for training and testing cohorts were 0.96 and 0.95, respectively, consistent with good system performance (21).…”

Segmentation and identification of fatty infiltration of the erector spinae using deep learning

“…Segmentation must be efficient and objective for MFI analysis to influence clinical practice. Recent advances in deep learning have facilitated the autonomous segmentation of PSM, allowing them to be assessed at scale; however, these metrics focus on overall muscle segmentation and exhibit decreased performance when segmenting muscles with increased fat infiltration 20,22 . To our knowledge, we present the first non-manual method for assessing and evaluating fat within the paraspinal musculature.…”