Automated image analysis of lateral roentgen images of the spine using anatomic models

Abstract

Development of a software for fully automated image analysis of lateral lumbar spine X-rays. Using the concept of active shape models, we developed a software that produces a form model of the lumbar spine from lateral lumbar spine radiographs and runs an automated image segmentation. This model is able to detect lumbar vertebrae automatically after the filtering of digitized X-ray images. The model was trained with 20 lateral lumbar spine radiographs with no pathological findings before we evaluated the software with 30 further X-ray images which were sorted by image quality ranging from one (best) to three (worst). There were 10 images for each quality. Image recognition strongly depended on image quality. In group one 52 and in group two 51 out of 60 vertebral bodies including the sacrum were recognized, but in group three only 18 vertebral bodies were properly identified. Fully automated and reliable recognition of vertebral bodies from lateral spine radiographs using the concept of active shape models is possible. The precision of this technique is limited by the superposition of different structures. Further improvements are necessary. Therefore standardized image quality and enlargement of the training data set are required.