Segmentation and Identification of Vertebrae in CT Scans Using CNN, k-Means Clustering and k-NN

The accurate segmentation and identification of vertebrae presents the foundations for spine analysis including fractures, malfunctions and other visual insights. The large-scale vertebrae segmentation challenge (VerSe), organized as a competition at the Medical Image Computing and Computer Assisted Intervention (MICCAI), is aimed at vertebrae segmentation and labeling. In this paper, we propose a framework that addresses the tasks of vertebrae segmentation and identification by exploiting both deep learning and classical machine learning methodologies. The proposed solution comprises two phases: a binary fully automated segmentation of the whole spine, which exploits a 3D convolutional neural network, and a semi-automated procedure that allows locating vertebrae centroids using traditional machine learning algorithms. Unlike other approaches, the proposed method comes with the added advantage of no requirement for single vertebrae-level annotations to be trained. A dataset of 214 CT scans has been extracted from VerSe’20 challenge data, for training, validating and testing the proposed approach. In addition, to evaluate the robustness of the segmentation and labeling algorithms, 12 CT scans from subjects affected by severe, moderate and mild scoliosis have been collected from a local medical clinic. On the designated test set from Verse’20 data, the binary spine segmentation stage allowed to obtain a binary Dice coefficient of 89.17%, whilst the vertebrae identification one reached an average multi-class Dice coefficient of 90.09%. In order to ensure the reproducibility of the algorithms hereby developed, the code has been made publicly available.