Segmentation of tibiofemoral joint tissues from knee MRI using MtRA-Unet and incorporating shape information: Data from the Osteoarthritis Initiative

Knee Osteoarthritis (KOA) is the third most prevalent Musculoskeletal Disorder (MSD) after neck and back pain. To monitor such a severe MSD, a segmentation map of the femur, tibia and tibiofemoral cartilage is usually accessed using the automated segmentation algorithm from the Magnetic Resonance Imaging (MRI) of the knee. But, in recent works, such segmentation is conceivable only from the multistage framework thus creating data handling issues and needing continuous manual inference rendering it unable to make a quick and precise clinical diagnosis. In order to solve these issues, in this paper the Multi-Resolution Attentive-Unet (MtRA-Unet) is proposed to segment the femur, tibia and tibiofemoral cartilage automatically. The proposed work has included a novel Multi-Resolution Feature Fusion (MRFF) and Shape Reconstruction (SR) loss that focuses on multi-contextual information and structural anatomical details of the femur, tibia and tibiofemoral cartilage. Unlike previous approaches, the proposed work is a single-stage and end-to-end framework producing a Dice Similarity Coefficient (DSC) of 98.5% for the femur, 98.4% for the tibia, 89.1% for Femoral Cartilage (FC) and 86.1% for Tibial Cartilage (TC) for critical MRI slices that can be helpful to clinicians for KOA grading. The time to segment MRI volume (160 slices) per subject is 22 sec. which is one of the fastest among state-of-the-art. Moreover, comprehensive experimentation on the segmentation of FC and TC which is of utmost importance for morphology-based studies to check KOA progression reveals that the proposed method has produced an excellent result with binary segmentation