CNN-based fully automatic wrist cartilage volume quantification in MR Image

TL;DR

This study develops and evaluates a CNN-based fully automatic segmentation method for wrist cartilage in MRI, demonstrating superior performance over previous models and potential clinical utility.

Contribution

It introduces optimized U-Net variants with attention mechanisms specifically tailored for wrist cartilage segmentation, outperforming previous patch-based CNNs.

Findings

U-Net with attention layers achieved the highest segmentation accuracy.

The proposed method showed lower volume error and higher correlation with manual segmentation.

Reproducibility of the CNN was better than manual segmentation.

Abstract

Detection of cartilage loss is crucial for the diagnosis of osteo- and rheumatoid arthritis. A large number of automatic segmentation tools have been reported so far for cartilage assessment in magnetic resonance images of large joints. As compared to knee or hip, wrist cartilage has a more complex structure so that automatic tools developed for large joints are not expected to be operational for wrist cartilage segmentation. In that respect, a fully automatic wrist cartilage segmentation method would be of high clinical interest. We assessed the performance of four optimized variants of the U-Net architecture with truncation of its depth and addition of attention layers (U-Net_AL). The corresponding results were compared to those from a patch-based convolutional neural network (CNN) we previously designed. The segmentation quality was assessed on the basis of a comparative analysis with manual segmentation using several morphological (2D DSC, 3D DSC, precision) and a volumetric metrics. The four networks outperformed the patch-based CNN in terms of segmentation homogeneity and quality. The median 3D DSC value computed with the U-Net_AL (0.817) was significantly larger than the corresponding DSC values computed with the other networks. In addition, the U-Net_AL CNN provided the lowest mean volume error (17%) and the highest Pearson correlation coefficient (0.765) with respect to the ground truth. Of interest, the reproducibility computed from using U-Net_AL was larger than the reproducibility of the manual segmentation. U-net convolutional neural network with additional attention layers provides the best wrist cartilage segmentation performance. In order to be used in clinical conditions, the trained network can be fine-tuned on a dataset representing a group of specific patients. The error of cartilage volume measurement should be assessed independently using a non-MRI method.