title: Semi-automatic volumetric segmentation of the upper airways in patients with pierre robin sequence.
abstract: Pierre Robin malformation is a rare craniofacial dysmorphism whose pathogenesis is multifactorial. Although there is some agreement in non-invasive treatment in less severe cases, the dispute is still open on cases with severe respiratory impairment. We present a semi-automatic novel diagnostic tool for calculating upper airway volume, in order to eventually address surgery in patients with Pierre Robin Sequence (PRS). Multidetector CT datasets of two patients and two controls were tested to assess the proposed method for ROI segmentation, upper airway volume computation and three-dimensional reconstructions. The experimental results show an irregular pattern and a severely reduced cross-sectional area (CSA) with a mean value of 8.3808 mm(2) in patients with PRS and a mean CSA value of 33.7692 mm(2) in controls (a ΔCSA of about -75%). Moreover, the similarity indexes and sensitivity/specificity values obtained showed a good segmentation performance. In particular, mean values of Jaccard and Dice similarity indexes were 91.69% and 94.07%, respectively, while the mean values of specificity and sensitivity were 96.69% and 98.03%, respectively. The proposed tool represents an easy way to perform a quantitative analysis of airway volume and useful 3D reconstructions.
authors.affiliation: Department of Biopathology and Medical and Forensic Biotechnologies - Section of Radiological Sciences, University of Palermo; Palermo, Italy - sergio.salerno@unipa.it.
authors.forename: Sergio
authors.initials: S
authors.lastname: Salerno
authors.affiliation: Department of Biopathology and Medical and Forensic Biotechnologies - Section of Radiological Sciences, University of Palermo; Palermo, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Gagliardo
authors.affiliation: Department of Biopathology and Medical and Forensic Biotechnologies - Section of Radiological Sciences, University of Palermo; Palermo, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Vitabile
authors.affiliation: Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR); Cefalù, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Militello
authors.affiliation: Department of Science for Health Promotion and Mother and Child Care, University of Palermo; Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Tona
authors.affiliation: Department of Science for Health Promotion and Mother and Child Care, University of Palermo; Palermo, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Giuffrè
authors.affiliation: Department of Biopathology and Medical and Forensic Biotechnologies - Section of Radiological Sciences, University of Palermo; Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lo Casto
authors.affiliation: Department of Biopathology and Medical and Forensic Biotechnologies - Section of Radiological Sciences, University of Palermo; Palermo, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Midiri
mesh_terms: D000402:Airway Obstruction / Q000000981:diagnostic imaging*; D019412:Anatomy, Cross-Sectional; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D007830:Larynx / Q000000981:diagnostic imaging*; D008297:Male; D061330:Multidetector Computed Tomography / Q000379:methods*; D009929:Organ Size; D010614:Pharynx / Q000000981:diagnostic imaging*; D010855:Pierre Robin Syndrome / Q000000981:diagnostic imaging*
keywords: 3D rendering; Pierre Robin sequence; airway model reconstruction; airways segmentation; multidetector CT; region growing