Improved subcutaneous edema segmentation on abdominal CT using a generated adipose tissue density prior

Abstract

Purpose Edema, or swelling, is a common symptom of kidney, heart, and liver disease. Volumetric edema measurement is potentially clinically useful. Edema can occur in various tissues. This work focuses on segmentation and volume measurement of one common site, subcutaneous adipose tissue. Methods The density distributions of edema and subcutaneous adipose tissue are represented as a two-class Gaussian mixture model (GMM). In previous work, edema regions were segmented by selecting voxels with density values within the edema density distribution. This work improves upon the prior work by generating an adipose tissue mask without edema through a conditional generative adversarial network. The density distribution of the generated mask was imported into a Chan-Vese level set framework. Edema and subcutaneous adipose tissue are separated by iteratively updating their respective density distributions. Results Validation results on 25 patients with edema showed that the segmentation accuracy significantly improved. Compared to GMM, the average Dice Similarity Coefficient increased from 56.0 to 61.7% ($$p<0.05$$ p < 0.05 ) and the relative volume difference decreased from 36.5 to 30.2% ($$p<0.05$$ p < 0.05 ). Conclusion The generated adipose tissue density prior improved edema segmentation accuracy. Accurate edema volume measurement may prove clinically useful.