Quantitative susceptibility mapping (QSM) is a promising iron quantification method for assessing subcortical deep gray matter (SGM) in various neurodegenerative diseases. The accuracy of the measurement depends largely on the accuracy of the structural segmentation. Manually drawn regions-of-interest from a well-trained specialist are often the best but are very time-consuming. In this work, we propose an automatic segmentation method for DGM iron quantification by taking advantage of a hybrid image approach combining T1W images and QSM data. Preliminary results on 5 stroke patients presented an overall 77.8±5.8% Dice coefficient compared to the manually drawn ground truth. The measured susceptibility of the DGM showed good agreement between both methods.
Introduction
Data Acquisition: This study was approved by the local IRB. Five stroke patients were recruited and were scanned on a 3T Siemens Trio Tim. The STAGE protocol was used for data acquisition. STAGE generates a number of qualitative and quantitative images, two of which we use in this study: whole brain QSM data and a specially enhanced set of T1W images with improved GM and WM contrast. The latter offers a major advantage in boundary detection for most structures while the former offers good boundaries for iron containing structures such as the Globus pallidus (GP).
Data processing: There are three major steps to implementing this auto-segmentation approach (Figure 1). Step 1: We generated a 1mm isotropic template from a high quality 3D T1W data set by manually drawing the structures and combining it with the QSM information to ensure reasonable choices for the GP and other basal ganglia structures. We then manually labeled 5 pairs of these structures (Caudate nucleus (CN), Putamen (PUT), GP, Red nucleus (RN), Substantia nigra (SN)). This template data is then mapped to the data for any given individual using a global deformable registration and then, for the CN and PUT, we use a local registration. All patient data are resampled to 1 mm isotropic resolution for this process. Background signal is removed using the automated brain extraction tool (BET) [6]. We chose the Versor3D method with finite processing to do the rigid registration and then performed a B-Splines multi-modality image registration in 3D with ITK [7,8]. We set the node of the B-Spline grid to 5 for global, and 10 for local deformable registration. We used the LBFGSB optimizer which is suitable for a large group of parameters to find the optimal parameters [9, 10]. Finally the data was cropped back to its original form. Step 2: The hybrid image was obtained using the formula: $$$I_{hybrid}=I_{T1WE}-I_{QSM}$$$for segmenting the PUT (Figure 2). For other structures, since density distribution changed between different cases, we use the first step output as the initial region. We calculate the mean value and the standard deviation of each region. Then we set a threshold to remove points not belonging to this structure. Our method is sequence parameter independent. Step 3: Boundary detection with a 3D dynamic programming (DP) centerline driven algorithm [11]. We find the centerline using a morphological skeleton, erosion and opening operation iteratively as follows:
$$S(X)=\bigcup_{r=0}^RS_r(X)$$
$$S_r(X)=X\ominus rB-[(X\ominus rB)\circ drB]$$
where rB is the erosion template, drB is the open template, and $$$(X\ominus rB)$$$ is the erosion on image X. R is the last operation when the image is empty. $$$\ominus$$$ is the erosion operation, and $$$\circ$$$ is the open operation. We already have the initial boundary from previous operations. Then, we update the DP boundary along with the centerline points (Figure 3):
To measure the accuracy of the proposed segmentation methods, the 5 pairs of DGM were manually segmented by two well trained observers, as ground truth; and compared with the automatic segmentation using the Dice coefficient.
Results
A representative case is shown in Figure 4. Compared to the ground truth, the dice coefficients of the proposed method were 79.4±4.1% for CN, 77.1±5.7% for PUT, 80.8±2.7% for GP, 79.9±6.7 for RN and 71.6±4.6% for SN, respectively. The susceptibility values measured using the automatic segmentation agreed well with those measured manually (Figure 5).Discussion and Conclusion
Smaller structures resulted in a lower Dice value while larger structures had higher Dice. The measured susceptibility values using the manual masks were lower than those measured automatically, since pixels belonging to the background tissue were included in the manual masks more than the automated masks. However, the overall measured susceptibilities were consistent between manual and automatic measurements. In conclusion, we developed an automatic segmentation algorithm for DGM which can benefit both research and clinical utility.[1] Haacke EM, Liu S, Buch S, Zheng W, Wu D, Ye Y. Quantitative susceptibility mapping: current status and future directions. Magn Reson Imaging 2015;33:1–25. doi:10.1016/j.mri.2014.09.004.
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