Open AccessValidating a Semi-Automated Technique for Segmenting Femoral Articular Cartilage on Ultrasound Images
Author(s) -
Matthew S. Harkey,
Nicholas Michel,
Christopher Kuenze,
Ryan S. Fajardo,
Matt Salzler,
Jeffrey B. Driban,
Ilker Hacihaliloglu
Publication year - 2022
Publication title -
cartilage
Language(s) - English
Resource type - Journals
eISSN - 1947-6043
pISSN - 1947-6035
DOI - 10.1177/19476035221093069
Subject(s) - segmentation , sørensen–dice coefficient , intraclass correlation , ultrasound , cartilage , medicine , pearson product moment correlation coefficient , anterior cruciate ligament , image segmentation , biomedical engineering , artificial intelligence , nuclear medicine , computer science , radiology , anatomy , mathematics , psychometrics , clinical psychology , statistics
Objective To validate a semi-automated technique to segment ultrasound-assessed femoral cartilage without compromising segmentation accuracy to a traditional manual segmentation technique in participants with an anterior cruciate ligament injury (ACL).Design We recruited 27 participants with a primary unilateral ACL injury at a pre-operative clinic visit. One investigator performed a transverse suprapatellar ultrasound scan with the participant’s ACL injured knee in maximum flexion. Three femoral cartilage ultrasound images were recorded. A single expert reader manually segmented the femoral cartilage cross-sectional area in each image. In addition, we created a semi-automatic program to segment the cartilage using a random walker-based method. We quantified the average cartilage thickness and echo-intensity for the manual and semi-automated segmentations. Intraclass correlation coefficients (ICC 2,k ) and Bland-Altman plots were used to validate the semi-automated technique to the manual segmentation for assessing average cartilage thickness and echo-intensity. A dice correlation coefficient was used to quantify the overlap between the segmentations created with the semi-automated and manual techniques.Results For average cartilage thickness, there was excellent reliability (ICC 2,k = 0.99) and a small mean difference (+0.8%) between the manual and semi-automated segmentations. For average echo-intensity, there was excellent reliability (ICC 2,k = 0.97) and a small mean difference (−2.5%) between the manual and semi-automated segmentations. The average dice correlation coefficient between the manual segmentation and semi-automated segmentation was 0.90, indicating high overlap between techniques.Conclusions Our novel semi-automated segmentation technique is a valid method that requires less technical expertise and time than manual segmentation in patients after ACL injury.