Automated segmentation of the quadratus lumborum muscle from magnetic resonance images using a hybrid atlas based - geodesic active contour scheme.

This study presents a novel method for the automatic segmentation of the quadratus lumborum (QL) muscle from axial magnetic resonance (MR) images using a hybrid scheme incorporating the use of non-rigid registration with probabilistic atlases (PAs) and geodesic active contours (GACs). The scheme was evaluated on an MR database of 7mm axial images of the lumbar spine from 20 subjects (fast bowlers and athletic controls). This scheme involved several steps, including (i) image pre-processing, (ii) generation of PAs for the QL, psoas (PS) and erector spinae+multifidus (ES+MT) muscles and (iii) segmentation, using 3D GACs initialized and constrained by the propagation of the PAs using non-rigid registration. Pre-processing of the images involved bias field correction based on local entropy minimization with a bicubic spline model and a reverse diffusion interpolation algorithm to increase the slice resolution to 0.98 x 0.98 x 1.75mm. The processed images were then registered (affine and non-rigid) and used to generate an average atlas. The PAs for the QL, PS and ES+MT were then generated by propagation of manual segmentations. These atlases were further analysed with specialised filtering to constrain the QL segmentation from adjacent non-muscle tissues (kidney, fat). This information was then used in 3D GACs to obtain the final segmentation of the QL. The automatic segmentation results were compared with the manual segmentations using the Dice similarity metric (DSC), with a median DSC for the right and left QL muscles of 0.78 (mean = 0.77, sd=0.07) and 0.75 (mean =0.74, sd=0.07), respectively.