Deep Learning-Based Segmentation of Cervical Posterior Longitudinal Ligament Ossification in Computed Tomography Images and Assessment of Spinal Cord Compression: A Two-Center Study.

IF 1.9 4区 医学 Q3 CLINICAL NEUROLOGY
World neurosurgery Pub Date : 2025-02-01 Epub Date: 2025-01-09 DOI:10.1016/j.wneu.2024.123567
Baiyang Jiang, Jiayang Yan, Shaochun Xu, Qianxi Jin, Gang Xiang, Qingyang Yu, Yimin Huang, Chao Zheng, Xiao Hu, Li Fan, Yi Xiao, Xiang Wang, Shiyuan Liu
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引用次数: 0

Abstract

Objective: This study aims to develop a fully automated, computed tomography (CT)-based deep learning (DL) model to segment ossified lesions of the posterior longitudinal ligament and to measure the thickness of the ossified material and calculate the cervical spinal cord compression factor.

Methods: A total of 307 patients were enrolled, with 260 patients from Shanghai Changzheng Hospital, and 47 patients from the Traditional Chinese Medicine Hospital of Southwest Medical University. CT images were used to manually segment the Ossification of the posterior longitudinal ligament (OPLL) by 4 experienced radiologists. The DL model employing a 3-dimensional U-Net framework was developed to segment the OPLLs. The system also measures the thickness of the ossified material at its thickest point and the diameter of the spinal canal at the corresponding level. Segmentation performance was evaluated using the Dice Similarity Coefficient, Average Surface Distance, and intraclass correlation coefficient (ICC) between ground truth and segmentation volumes. Concordance between the radiologists' and the DL system's measurements of the ossified material thickness, residual spinal canal diameter at maximum compression, and cervical spinal cord compression coefficient was assessed in a randomly selected subset of 30 cases from the training set using ICCs and Bland-Altman plots.

Results: The DL system demonstrated average Dice Similarity Coefficient of 0.81, 0.75, and 0.71 for the training, internal validation, and external test sets, respectively. The mean Average Surface Distance was 1.30 for the training set, 2.35 for the internal validation set, and 2.63 for the external test set. The ICC values of 0.958 for the thickness of the ossified material and 0.974 for the residual canal diameter measurement.

Conclusions: The proposed DL model effectively detects and separates ossification foci in OPLL on CT images. It exhibits comparable performance to radiologists in quantifying spinal cord compression metrics.

基于深度学习的CT图像分割颈椎后纵韧带骨化和脊髓压迫评估:一项双中心研究。
目的:本研究旨在开发一种全自动、基于ct的深度学习(DL)模型,对后纵韧带(OPLL)骨化病变进行分割,测量骨化材料的厚度并计算颈脊髓压缩因子。材料与方法:共纳入307例患者,其中上海长征医院260例,西南医科大学中医院47例。CT图像由四位经验丰富的放射科医生手工分割OPLL。采用三维U-Net框架开发DL模型,对opll进行分割。该系统还测量骨化材料在其最厚点的厚度和相应水平的椎管直径。使用Dice Similarity Coefficient (DSC)、Average Surface Distance (ASD)和ground truth与Segmentation volume之间的Intra-Class Correlation (ICC)来评估分割性能。使用ICCs和Bland-Altman图,从训练集中随机选择30例患者,评估放射科医生和DL系统测量的骨化材料厚度、最大压缩时残余椎管直径和颈脊髓压缩系数之间的一致性。结果:DL系统在训练集、内部验证集和外部测试集上的平均DSC分别为0.81、0.75和0.71。训练集的平均ASD为1.30,内部验证集为2.35,外部测试集为2.63。骨化材料厚度的类内相关系数(ICC)为0.958,残余管径测量为0.974。结论:所提出的DL模型能有效地检测和分离CT图像上OPLL的骨化病灶。它在量化脊髓压缩指标方面表现出与放射科医生相当的性能。
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来源期刊
World neurosurgery
World neurosurgery CLINICAL NEUROLOGY-SURGERY
CiteScore
3.90
自引率
15.00%
发文量
1765
审稿时长
47 days
期刊介绍: World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
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