DEEPBEAS3D: Deep Learning and B-Spline Explicit Active Surfaces

Deep learning-based automatic segmentation methods have become state-of-the-art. However, they are often not robust enough for direct clinical application, as domain shifts between training and testing data affect their performance. Failure in automatic segmentation can cause sub-optimal results that require correction. To address these problems, we propose a novel 3D extension of an interactive segmentation framework that represents a segmentation from a convolutional neural network (CNN) as a B-spline explicit active surface (BEAS). BEAS ensures segmentations are smooth in 3D space, increasing anatomical plausibility, while allowing the user to precisely edit the 3D surface. We apply this framework to the task of 3D segmentation of the anal sphincter complex (AS) from transperineal ultrasound (TPUS) images, and compare it to the clinical tool used in the pelvic floor disorder clinic (4D View VOCAL, GE Healthcare; Zipf, Austria). Experimental results show that: 1) the proposed framework gives the user explicit control of the surface contour; 2) the perceived workload calculated via the NASA-TLX index was reduced by 30% compared to VOCAL; and 3) it required 7 0% (170 seconds) less user time than VOCAL (p< 0.00001)

Interactive Segmentation via Deep Learning and B-Spline Explicit Active Surfaces

Automatic medical image segmentation via convolutional neural networks (CNNs) has shown promising results. However, they may not always be robust enough for clinical use. Sub-optimal segmentation would require clinician's to manually delineate the target object, causing frustration. To address this problem, a novel interactive CNN-based segmentation framework is proposed in this work. The aim is to represent the CNN segmentation contour as B-splines by utilising B-spline explicit active surfaces (BEAS). The interactive element of the framework allows the user to precisely edit the contour in real-time, and by utilising BEAS it ensures the final contour is smooth and anatomically plausible. This framework was applied to the task of 2D segmentation of the levator hiatus from 2D ultrasound (US) images, and compared to the current clinical tools used in pelvic floor disorder clinic (4DView, GE Healthcare; Zipf, Austria). Experimental results show that: 1) the proposed framework is more robust than current state-of-the-art CNNs; 2) the perceived workload calculated via the NASA-TLX index was reduced more than half for the proposed approach in comparison to current clinical tools; and 3) the proposed tool requires at least 13 seconds less user time than the clinical tools, which was significant (p=0.001).