title: Smoothing lung segmentation surfaces in three-dimensional X-ray CT images using anatomic guidance.
abstract: OBJECTIVE
  Automatic lung segmentation in volumetric computed tomography (CT) images has been extensively investigated, and several methods have been proposed. Most methods distinguish the lung parenchyma from the surrounding anatomy based on the difference in CT attenuation values. This leads to an irregular and inconsistent lung boundary for the regions near the mediastinum, which can cause inconsistent boundaries both across subjects and within subjects scanned at different intervals of time. Processes like lung image registration and lung atlas construction can be affected by such inconsistencies. Therefore there is a need for a more consistent lung surface near the mediastinum.
  
  
  METHODS
  This paper presents a fully automatic method for the three-dimensional smoothing of the lung boundary using information from the segmented human airway tree. First, using the segmented airway tree, we define a bounding box around the mediastinum for each lung, within which all operations are performed. We then define all generations of the airway tree distal to the right and left main stem bronchi to be part of the respective lungs and exclude all other segments. Finally, we perform a fast morphological closing with an ellipsoidal kernel to smooth the surface of the lung.
  
  
  RESULTS
  This method has been tested by processing the segmented lungs from eight normal datasets. The mean value of the magnitude of curvedness of the lung contours, averaged over all the datasets, is 0.13 postsmoothing, compared with 4.91 before smoothing. The accuracy of the lung contours after smoothing is assessed by comparing the automatic results to manually traced smooth lung borders by a human analyst. Averaged over all volumes, the root mean square difference between human and computer borders is 0.8691 mm after smoothing, compared with 1.3012 mm before smoothing. The mean similarity index, which is an area overlap measure based on the kappa statistic, is 0.9958 (SD 0.0032), after smoothing.
  
  
  CONCLUSIONS
  We have described a novel scheme for smoothing the lung contour around the mediastinum. The method is based on using anatomic information from the segmented airway tree. The validation results show that there is good agreement between manual and computer results. Because there are no accepted criteria for defining the lung boundary near the mediastinum, we believe our method of defining the boundary based on the structure of the airway tree provides a good basis for three-dimensional smoothing.
authors.affiliation: Department of Biomedical Engineering, University of Iowa, Iowa City, IA 52242, USA. sukil@engineering.uiowa.edu
authors.forename: Soumik
authors.initials: S
authors.lastname: Ukil
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Reinhardt
mesh_terms: D000465:Algorithms; D001185:Artificial Intelligence; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D016247:Information Storage and Retrieval / Q000379:methods*; D008168:Lung / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D008482:Mediastinum / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D010363:Pattern Recognition, Automated / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D013382:Subtraction Technique; D014057:Tomography, X-Ray Computed / Q000379:methods*