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Published in: European Radiology 1/2021

Open Access 01-01-2021 | Computed Tomography | Musculoskeletal

Deep learning for the rapid automatic quantification and characterization of rotator cuff muscle degeneration from shoulder CT datasets

Authors: Elham Taghizadeh, Oskar Truffer, Fabio Becce, Sylvain Eminian, Stacey Gidoin, Alexandre Terrier, Alain Farron, Philippe Büchler

Published in: European Radiology | Issue 1/2021

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Abstract

Objectives

This study aimed at developing a convolutional neural network (CNN) able to automatically quantify and characterize the level of degeneration of rotator cuff (RC) muscles from shoulder CT images including muscle atrophy and fatty infiltration.

Methods

One hundred three shoulder CT scans from 95 patients with primary glenohumeral osteoarthritis undergoing anatomical total shoulder arthroplasty were retrospectively retrieved. Three independent radiologists manually segmented the premorbid boundaries of all four RC muscles on standardized sagittal-oblique CT sections. This premorbid muscle segmentation was further automatically predicted using a CNN. Automatically predicted premorbid segmentations were then used to quantify the ratio of muscle atrophy, fatty infiltration, secondary bone formation, and overall muscle degeneration. These muscle parameters were compared with measures obtained manually by human raters.

Results

Average Dice similarity coefficients for muscle segmentations obtained automatically with the CNN (88% ± 9%) and manually by human raters (89% ± 6%) were comparable. No significant differences were observed for the subscapularis, supraspinatus, and teres minor muscles (p > 0.120), whereas Dice coefficients of the automatic segmentation were significantly higher for the infraspinatus (p < 0.012). The automatic approach was able to provide good–very good estimates of muscle atrophy (R2 = 0.87), fatty infiltration (R2 = 0.91), and overall muscle degeneration (R2 = 0.91). However, CNN-derived segmentations showed a higher variability in quantifying secondary bone formation (R2 = 0.61) than human raters (R2 = 0.87).

Conclusions

Deep learning provides a rapid and reliable automatic quantification of RC muscle atrophy, fatty infiltration, and overall muscle degeneration directly from preoperative shoulder CT scans of osteoarthritic patients, with an accuracy comparable with that of human raters.

Key Points

• Deep learning can not only segment RC muscles currently available in CT images but also learn their pre-existing locations and shapes from invariant anatomical structures visible on CT sections.
• Our automatic method is able to provide a rapid and reliable quantification of RC muscle atrophy and fatty infiltration from conventional shoulder CT scans.
• The accuracy of our automatic quantitative technique is comparable with that of human raters.
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Metadata
Title
Deep learning for the rapid automatic quantification and characterization of rotator cuff muscle degeneration from shoulder CT datasets
Authors
Elham Taghizadeh
Oskar Truffer
Fabio Becce
Sylvain Eminian
Stacey Gidoin
Alexandre Terrier
Alain Farron
Philippe Büchler
Publication date
01-01-2021
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 1/2021
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-07070-7

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