Steve Cheuk Ngai Hui1, Teng Zhang1, Defeng Wang1, and Winnie Chiu Wing Chu1
1Dept. of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
Synopsis
This abstract introduces the use of
wheel-template to perform segmentation on subcutaneous adipose tissue (SAT)
and visceral adipose tissue (VAT) at the abdominal region. The proposed method
detects narrow regions between SAT and VAT, and uses line cut to separate two
types of tissues based on MRI data. It performs well on obese individuals and
the obtained results are correlated to those obtained from a semi-automatic
method. A quantitative measurement of SAT and VAT is important as they are
developed from different pathways and suggested to be related to different
chronic diseases.PURPOSE
Several
methods have been proposed to segment subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) based on active contour
algorithm, geometrical model, registration based, graph cut, thresholding and
intensity level (1-6). Nevertheless,
morphological or deformational based segmentation is challenging to obtain high
accuracy due to high variations of abdominal shape especially at the pelvis
regions. The proposed study suggests a different approach by cutting the
boundary between SAT and VAT using circular templates and line-cut that
satisfied the given constraints to detect the narrow boundaries.
METHODS
Subjects: Fourteen obese
adolescents (Female: 9, Male: 5, age: 17.3±1.4, BMI: 33.2±3.6) under the health
monitoring program were recruited from the out-patient clinic at the university
teaching hospital. Inclusion criteria included age between 13-19 years, BMI
> 25, and had no long term diseases affecting the weight. Image acquisition: The abdominal
regions of all subjects were scanned using a 3.0 T whole-body scanner (Achieva
X-series, Philips Medical System, Best, The Netherlands) with a 16-channel
SENSE-XL-Torso array coil. The abdominal regions covered from the dome of
diaphragm to the pubic symphysis and divided into three sections during the
scan. Chemical-shift water-fat images were acquired using a 3D multi echo DIXON
sequence (TR = 13 ms, TE1/TE2 = 1.2/2.2 ms, flip angle = 3°, FOV = 450
(right-left) x 340 (AP) mm, slice thickness = 10 mm, number of slices = 30) to
yield co-registered water, fat, in-phase, and opposed-phase image series. Image preprocessing: An in-house
segmentation algorithm was developed on Matlab (R2011a,
Mathworks, Natick, USA) to separate SAT and WAT at the abdominal
regions. Smoothing and de-noising were performed on the Fat-only series images followed
by thresholding using Otsu's method to create a binary mask (7,8). The arms of the subjects were removed
by separating from the largest connected regions. Line-Cut: To separate the connected regions between SAT and VAT (figure 1), a circular mask
was created using Midpoint circle algorithm followed by adding straight lines on
the mask through the center using Bresenham's line algorithm. The numbers of
lines depended on the diameter of the circle. The adipose tissues (white pixels)
were scanned with the template, and if both end points of any line on the
circular mask touched non-adipose tissues (dark pixels), the coordination set
of the line points were labeled and a black line would be drawn after the scan
(figure 2). SAT was
segmented by getting the largest connected component and VAT was obtained by
subtracting the SAT from the binary mask as shown in figure 3. Validation:
Results from the proposed method were compared with the results obtained using
a semi-automatic segmentation on ITK-SNAP 2.40 (9). Pearson
Correlation
Coefficient was measured to test the relationship between two sets of results.
RESULTS
Results are presented in VAT, SAT and total adipose tissue
(TAT) as shown in table 1.Pearson
correlation coefficient indicates that results from the proposed method are significantly
correlated with those from the semi-automatic method.
DISCUSSION
The proposed method is able to work on abdominal regions
with large shape variation. It overcomes the challenges in other methods based
on active contour and deformable model. It detects narrow connecting parts
using a wheel-template (circular template) with lines through the center. The
proposed method is also less sensitive to noise, motion artifacts and signal
inhomogeneity as it only detects narrow boundaries between SAT and VAT. The
volume of SAT would be slightly underestimated as a small number of pixels at
the outer and inner boundary are removed due to the process of the line cut
algorithm when the template is scanning at the edge. These pixels are presented
in VAT results as shown in the small white pixels along the boundary in figure
3c. VAT volume would be overestimated on the other hand due to the edge pixels
from SAT and the femur bones and joints at the pelvis area. TAT results are
very close in both methods due to using the same raw images and the same thresholding
method to measure the adipose tissues. Testing on normal subjects will be conducted
in the near future and one potential problem would be on very thin individuals
with a small thickness of SAT which is thinner than the diameter of the
predefined circular template. In conclusion, as SAT and VAT are different in
many aspects, an accurate and quantitative measurement allows physicians to
evaluate the efficacy of treatments against obesity and the relationship
between diseases to different kinds of adipose tissues.
Acknowledgements
The work described in this paper was fully supported by a grant from the Research Grants Council of the Hong Kong Special Administrative Region, China (Project No. SEG CUHK_02)References
1. Kullberg J, Karlsson AK, Stokland E,
Svensson PA, Dahlgren J. Adipose tissue distribution in children: automated
quantification using water and fat MRI. J Magn Reson Imaging
2010;32(1):204-210.
2. Kullberg
J, Ahlstrom H, Johansson L, Frimmel H. Automated and reproducible segmentation
of visceral and subcutaneous adipose tissue from abdominal MRI. Int J Obes
(Lond) 2007;31(12):1806-1817.
3. Positano
V, Gastaldelli A, Sironi AM, Santarelli MF, Lombardi M, Landini L. An accurate
and robust method for unsupervised assessment of abdominal fat by MRI. J Magn
Reson Imaging 2004;20(4):684-689.
4. Wald
D, Teucher B, Dinkel J, et al. Automatic quantification of subcutaneous and
visceral adipose tissue from whole-body magnetic resonance images suitable for
large cohort studies. J Magn Reson Imaging 2012;36(6):1421-1434.
5. Joshi
AA, Hu HH, Leahy RM, Goran MI, Nayak KS. Automatic intra-subject registration-based
segmentation of abdominal fat from water-fat MRI. J Magn Reson Imaging
2013;37(2):423-430.
6. Sadananthan
SA, Prakash B, Leow MK, et al. Automated segmentation of visceral and
subcutaneous (deep and superficial) adipose tissues in normal and overweight
men. J Magn Reson Imaging 2015;41(4):924-934.
7. Coupe
P, Manjon JV, Gedamu E, Arnold D, Robles M, Collins DL. Robust Rician noise
estimation for MR images. Med Image Anal 2010;14(4):483-493.
8. Otsu
N. A Threshold Selection Method from Gray-Level Histograms. Systems, Man and
Cybernetics, IEEE Transactions on 1979;9(1):62-66.
9. Yushkevich
PA, Piven J, Hazlett HC, et al. User-guided 3D active contour segmentation of
anatomical structures: Significantly improved efficiency and reliability.
NeuroImage 2006;31(3):1116-1128.