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Automatic spine segmentation, based on ultrasound volume projection imaging (VPI), is of great value in clinical applications to diagnose scoliosis in teenagers. In this paper, we propose a novel framework to improve the segmentation accuracy on spine images via structure-enhanced attentive learning. Since the spine bones contain strong prior knowledge of their shapes and positions in ultrasound VPI images, we propose to encode this information into the semantic representations in an attentive manner. We first revisit the self-attention mechanism in representation learning, and then present a strategy to introduce the structural knowledge into the key representation in self-attention. By this means, the network explores both the contextual and structural information in the learned features, and consequently improves the segmentation accuracy. We conduct various experiments to demonstrate that our proposed method achieves promising performance on spine image segmentation, which shows great potential in clinical diagnosis.

Ultrasound volume projection imaging (VPI) has shown to be appealing from a clinical perspective, because of its harmlessness, flexibility, and efficiency in scoliosis assessment. However, the limitations in hardware devices degrade the resultant image content with strong structured noise. Owing to the unavailability of reference data and the unpredictable degradation model, VPI image recovery is a challenging problem. In this paper, we propose a novel framework to learn the structured noise removal from unpaired samples. We introduce the attention mechanism into the generative adversarial network to enhance the learning by focusing on the salient corrupted patterns. We also present a dual adversarial learning strategy and integrate the denoiser with a segmentation model to produce the task-oriented noiseless estimation. Experimental results show that the proposed method can improve both the visual quality and the segmentation accuracy on spine images.

Vertebral labelling and segmentation are two fundamental tasks in an automated spine processing pipeline. Reliable and accurate processing of spine images is expected to benefit clinical decision-support systems for diagnosis, surgery planning, and population-based analysis on spine and bone health. However, designing automated algorithms for spine processing is challenging predominantly due to considerable variations in anatomy and acquisition protocols and due to a severe shortage of publicly available data. Addressing these limitations, the Large Scale Vertebrae Segmentation Challenge (VerSe) was organised in conjunction with the International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) in 2019 and 2020, with a call for algorithms towards labelling and segmentation of vertebrae. Two datasets containing a total of 374 multi-detector CT scans from 355 patients were prepared and 4505 vertebrae have individually been annotated at voxel-level by a human-machine hybrid algorithm (https://osf.io/nqjyw/, https://osf.io/t98fz/). A total of 25 algorithms were benchmarked on these datasets. In this work, we present the the results of this evaluation and further investigate the performance-variation at vertebra-level, scan-level, and at different fields-of-view. We also evaluate the generalisability of the approaches to an implicit domain shift in data by evaluating the top performing algorithms of one challenge iteration on data from the other iteration. The principal takeaway from VerSe: the performance of an algorithm in labelling and segmenting a spine scan hinges on its ability to correctly identify vertebrae in cases of rare anatomical variations. The content and code concerning VerSe can be accessed at: https://github.com/anjany/verse., Comment: Challenge report for the VerSe 2019 and 2020. Published in Medical Image Analysis (DOI: https://doi.org/10.1016/j.media.2021.102166)

3D ultrasound imaging shows great promise for scoliosis diagnosis thanks to its low-costing, radiation-free and real-time characteristics. The key to accessing scoliosis by ultrasound imaging is to accurately segment the bone area and measure the scoliosis degree based on the symmetry of the bone features. The ultrasound images tend to contain many speckles and regular occlusion noise which is difficult, tedious and time-consuming for experts to find out the bony feature. In this paper, we propose a robust bone feature segmentation method based on the U-net structure for ultrasound spine Volume Projection Imaging (VPI) images. The proposed segmentation method introduces a total variance loss to reduce the sensitivity of the model to small-scale and regular occlusion noise. The proposed approach improves 2.3% of Dice score and 1% of AUC score as compared with the u-net model and shows high robustness to speckle and regular occlusion noise., SMC2020

3D ultrasound imaging has become one of the common diagnosis ways to assess scoliosis since it is radiation-free, real-time, and low-cost. Spine curvature angle measurement is an important step to assess scoliosis precisely. One way to calculate the angle is using the vertebrae features of the 2-D coronal images to identify the most tilted vertebrae. To do the measurement, the segmentation of the transverse vertebrae is an important step. In this paper, we propose a dual-task ultrasound transverse vertebrae segmentation network (D-TVNet) based on U-Net. First, we arrange an auxiliary shape regularization network to learn the contour segmentation of the bones. It improves the boundary segmentation and anti-interference ability of the U-Net by fusing some of the features of the auxiliary task and the main task. Then, we introduce the atrous spatial pyramid pooling (ASPP) module to the end of the down-sampling stage of the main task stream to improve the relative feature extraction ability. To further improve the boundary segmentation, we extendedly fuse the down-sampling output features of the auxiliary network in the ASPP. The experiment results show that the proposed D-TVNet achieves the best dice score of 86.68% and the mean dice score of 86.17% based on cross-validation, which is an improvement of 5.17% over the baseline U-Net. An automatic ultrasound spine bone segmentation network with promising results has been achieved.