Automated and interactive approaches for optimal surface finding based segmentation of medical image data

Optimal surface finding (OSF), a graph-based optimization approach to image segmentation, represents a powerful framework for medical image segmentation and analysis. In many applications, a pre-segmentation is required to enable OSF graph construction. Also, the cost function design is critical for the success of OSF. In this thesis, two issues in the context of OSF segmentation are addressed. First, a robust model-based segmentation method suitable for OSF initialization is introduced. Second, an OSF-based segmentation refinement approach is presented.

For segmenting complex anatomical structures (e.g., lungs), a rough initial segmentation is required to apply an OSF-based approach. For this purpose, a novel robust active shape model (RASM) is presented. The RASM matching in combination with OSF is investigated in the context of segmenting lungs with large lung cancer masses in 3D CT scans. The robustness and effectiveness of this approach is demonstrated on 30 lung scans containing 20 normal lungs and 40 diseased lungs where conventional segmentation methods frequently fail to deliver usable results. The developed RASM approach is generally applicable and suitable for large organs/structures.

While providing high levels of performance in most cases, OSF-based approaches may fail in a local region in the presence of pathology or other local challenges. A new (generic) interactive refinement approach for correcting local segmentation errors based on the OSF segmentation framework is proposed. Following the automated segmentation, the user can inspect the result and correct local or regional segmentation inaccuracies by (iteratively) providing clues regarding the location of the correct surface. This expert information is utilized to modify the previously calculated cost function, locally re-optimizing the underlying modified graph without a need to start the new optimization from scratch. For refinement, a hybrid desktop/virtual reality user interface based on stereoscopic visualization technology and advanced interaction techniques is utilized for efficient interaction with the segmentations (surfaces). The proposed generic interactive refinement method is adapted to three applications. First, two refinement tools for 3D lung segmentation are proposed, and the performance is assessed on 30 test cases from 18 CT lung scans. Second, in a feasibility study, the approach is expanded to 4D OSF-based lung segmentation refinement and an assessment of performance is provided. Finally, a dual-surface OSF-based intravascular ultrasound (IVUS) image segmentation framework is introduced, application specific segmentation refinement methods are developed, and an evaluation on 41 test cases is presented. As demonstrated by experiments, OSF-based segmentation refinement is a promising approach to address challenges in medical image segmentation.