Automated segmentation of the injured spleen.
OBJECTIVE
To develop a novel automated method for segmentation of the injured spleen using morphological properties following abdominal trauma. Average attenuation of a normal spleen in computed tomography (CT) does not vary significantly between subjects. However, in the case of solid organ injury, the shape and attenuation of the spleen on CT may vary depending on the time and severity of the injury. Timely assessment of the severity and extent of the injury is of vital importance in the setting of trauma.


METHODS
We developed an automated computer-aided method for segmenting the injured spleen from CT scans of patients who had splenectomy due to abdominal trauma. We used ten subjects to train our computer-aided diagnosis (CAD) method. To validate the CAD method, we used twenty subjects in our testing group. Probabilistic atlases of the spleens were created using manually segmented data from ten CT scans. The organ location was modeled based on the position of the spleen with respect to the left side of the spine followed by the extraction of shape features. We performed the spleen segmentation in three steps. First, we created a mask of the spleen, and then we used this mask to segment the spleen. The third and final step was the estimation of the spleen edges in the presence of an injury such as laceration or hematoma.


RESULTS
The traumatized spleens were segmented with a high degree of agreement with the radiologist-drawn contours. The spleen quantification led to [Formula: see text] volume overlap, [Formula: see text] Dice similarity index, [Formula: see text] precision/sensitivity, [Formula: see text] volume estimation error rate, [Formula: see text] average surface distance/root-mean-squared error.


CONCLUSIONS
Our CAD method robustly segments the spleen in the presence of morphological changes such as laceration, contusion, pseudoaneurysm, active bleeding, periorgan and parenchymal hematoma, including subcapsular hematoma due to abdominal trauma. CAD of the splenic injury due to abdominal trauma can assist in rapid diagnosis and assessment and guide clinical management. Our segmentation method is a general framework that can be adapted to segment other injured solid abdominal organs.
Department of General Surgery, Bursa Military Hospital, Bursa, Turkey. dandinozgur@gmail.com.
Ozgür
O
Dandin
Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA.
Uygar
U
Teomete
Department of Electrical and Electronics Engineering, Istanbul Arel University, Istanbul, Turkey.
Onur
O
Osman
Department of Electrical and Electronics Engineering, Yeni Yuzyil University, Istanbul, Turkey.
Gökalp
G
Tulum
Department of Radiology, School of Medicine, Gulhane Military Medical Academy, Ankara, Turkey.
Tuncer
T
Ergin
Department of General Surgery, University Of Suleyman Demirel, Isparta, Turkey.
Mehmet Zafer
MZ
Sabuncuoglu
D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005431:Florida; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013154:Spleen / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed / Q000592:standards*; D055815:Young Adult
Computer; Diagnosis; Solid organ; Trauma