Automated glenoid bone loss measurement and segmentation in CT scans for pre-operative planning in shoulder instability

Reliable measurement of glenoid bone loss is essential for operative planning in shoulder instability, but current manual and semi-automated methods are time-consuming and often subject to interreader variability. We developed and validated a fully automated deep learning pipeline for measuring glenoid bone loss on three-dimensional computed tomography (CT) scans using a linear-based, en-face view, best-circle method. Shoulder CT images of 91 patients (average age, 40 years; range, 14-89 years; 65 men) were retrospectively collected along with manual labels including glenoid segmentation, landmarks, and bone loss measurements. The multi-stage algorithm has three main stages: (1) segmentation, where we developed a U-Net to automatically segment the glenoid and humerus; (2) anatomical landmark detection, where a second network predicts glenoid rim points; and (3) geometric fitting, where we applied principal component analysis (PCA), projection, and circle fitting to compute the percentage of bone loss. The automated measurements showed strong agreement with consensus readings and exceeded surgeon-to-surgeon consistency (intraclass correlation coefficient (ICC) 0.84 vs 0.78), including in low- and high-bone-loss subgroups (ICC 0.71 vs 0.63 and 0.83 vs 0.21, respectively; P < 0.001). For classifying patients into low, medium, and high bone-loss categories, the pipeline achieved a recall of 0.714 for low and 0.857 for high severity, with no low cases misclassified as high or vice versa. These results suggest that our method is a time-efficient and clinically reliable tool for preoperative planning in shoulder instability and for screening patients with substantial glenoid bone loss. Code and dataset are available at https://github.com/Edenliu1/Auto-Glenoid-Measurement-DL-Pipeline.

SegmentAnyBone: A Universal Model that Segments Any Bone at Any Location on MRI

Magnetic Resonance Imaging (MRI) is pivotal in radiology, offering non-invasive and high-quality insights into the human body. Precise segmentation of MRIs into different organs and tissues would be highly beneficial since it would allow for a higher level of understanding of the image content and enable important measurements, which are essential for accurate diagnosis and effective treatment planning. Specifically, segmenting bones in MRI would allow for more quantitative assessments of musculoskeletal conditions, while such assessments are largely absent in current radiological practice. The difficulty of bone MRI segmentation is illustrated by the fact that limited algorithms are publicly available for use, and those contained in the literature typically address a specific anatomic area. In our study, we propose a versatile, publicly available deep-learning model for bone segmentation in MRI across multiple standard MRI locations. The proposed model can operate in two modes: fully automated segmentation and prompt-based segmentation. Our contributions include (1) collecting and annotating a new MRI dataset across various MRI protocols, encompassing over 300 annotated volumes and 8485 annotated slices across diverse anatomic regions; (2) investigating several standard network architectures and strategies for automated segmentation; (3) introducing SegmentAnyBone, an innovative foundational model-based approach that extends Segment Anything Model (SAM); (4) comparative analysis of our algorithm and previous approaches; and (5) generalization analysis of our algorithm across different anatomical locations and MRI sequences, as well as an external dataset. We publicly release our model at https://github.com/mazurowski-lab/SegmentAnyBone.