Sample Size Effect on Musculoskeletal Segmentation: How Low Can We Go?

Abstract

Convolutional Neural Networks have emerged as a predominant tool in musculoskeletal medical image segmentation. It enables precise delineation of bone and cartilage in medical images. Recent developments in image processing and network architecture desire a reevaluation of the relationship between segmentation accuracy and the amount of training data. This study investigates the minimum sample size required to achieve clinically relevant accuracy in bone and cartilage segmentation using the nnU-Net methodology. In addition, the potential benefit of integrating available medical knowledge for data augmentation, a largely unexplored opportunity for data preprocessing, is investigated. The impact of sample size on the segmentation accuracy of the nnU-Net is studied using three distinct musculoskeletal datasets, including both MRI and CT, to segment bone and cartilage. Further, the use of model-informed augmentation is explored on two of the above datasets by generating new training samples implementing a shape model-informed approach. Results indicate that the nnU-Net can achieve remarkable segmentation accuracy with as few as 10–15 training samples on bones and 25–30 training samples on cartilage. Model-informed augmentation did not yield relevant improvements in segmentation results. The sample size findings challenge the common notion that large datasets are necessary to obtain clinically relevant segmentation outcomes in musculoskeletal applications.