Comparison of CLASS and ITK-SNAP in segmentation of urinary bladder in CT urography

Abstract

We are developing a computerized method for bladder segmentation in CT urography (CTU) for computeraided diagnosis of bladder cancer. We have developed a Conjoint Level set Analysis and Segmentation System (CLASS) consisting of four stages: preprocessing and initial segmentation, 3D and 2D level set segmentation, and post-processing. In case the bladder contains regions filled with intravenous (IV) contrast and without contrast, CLASS segments the noncontrast (NC) region and the contrast (C) filled region separately and conjoins the contours. In this study, we compared the performance of CLASS to ITK-SNAP 2.4, which is a publicly available software application for segmentation of structures in 3D medical images. ITK-SNAP performs segmentation by using the edge-based level set on preprocessed images. The level set were initialized by manually placing a sphere at the boundary between the C and NC parts of the bladders with C and NC regions, and in the middle of the bladders that had only C or NC region. Level set parameters and the number of iterations were chosen after experimentation with bladder cases. Segmentation performances were compared using 30 randomly selected bladders. 3D hand-segmented contours were obtained as reference standard, and computerized segmentation accuracy was evaluated in terms of the average volume intersection %, average % volume error, average absolute % volume error, average minimum distance, and average Jaccard index. For CLASS, the values for these performance metrics were 79.0±8.2%, 16.1±16.3%, 19.9±11.1%, 3.5±1.3 mm, 75.7±8.4%, respectively. For ITK-SNAP, the corresponding values were 78.8±8.2%, 8.3±33.1%, 24.2±23.7%, 5.2±2.6 mm, 71.0±15.4%, respectively. CLASS on average performed better and exhibited less variations than ITK-SNAP for bladder segmentation.