Interactive 3D medical image segmentation with energy-minimizing implicit functions

We present an interactive segmentation method for 3D medical images that reconstructs the surface of an object using energy-minimizing, smooth, implicit functions. This reconstruction problem is called variational interpolation. For an intuitive segmentation of medical images, variational interpolation can be based on a set of user-drawn, planar contours that can be arbitrarily oriented in 3D space. This also allows an easy integration of the algorithm into the common manual segmentation workflow, where objects are segmented by drawing contours around them on each slice of a 3D image. Because variational interpolation is computationally expensive, we show how to speed up the algorithm to achieve almost real-time calculation times while preserving the overall segmentation quality. Moreover, we show how to improve the robustness of the algorithm by transforming it from an interpolation to an approximation problem and we discuss a local interpolation scheme. A first evaluation of our algorithm by two experienced radiology technicians on 15 liver metastases and 1 liver has shown that the segmentation times can be reduced by a factor of about 2 compared to a slice-wise manual segmentation and only about one fourth of the contours are necessary compared to the number of contours necessary for a manual segmentation.