title: Combining split-and-merge and multi-seed region growing algorithms for uterine fibroid segmentation in MRgFUS treatments.
abstract: Uterine fibroids are benign tumors that can affect female patients during reproductive years. Magnetic resonance-guided focused ultrasound (MRgFUS) represents a noninvasive approach that uses thermal ablation principles to treat symptomatic fibroids. During traditional treatment planning, uterus, fibroids, and surrounding organs at risk must be manually marked on MR images by an operator. After treatment, an operator must segment, again manually, treated areas to evaluate the non-perfused volume (NPV) inside the fibroids. Both pre- and post-treatment procedures are time-consuming and operator-dependent. This paper presents a novel method, based on an advanced direct region detection model, for fibroid segmentation in MR images to address MRgFUS post-treatment segmentation issues. An incremental procedure is proposed: split-and-merge algorithm results are employed as multiple seed-region selections by an adaptive region growing procedure. The proposed approach segments multiple fibroids with different pixel intensity, even in the same MR image. The method was evaluated using area-based and distance-based metrics and was compared with other similar works in the literature. Segmentation results, performed on 14 patients, demonstrated the effectiveness of the proposed approach showing a sensitivity of 84.05 %, a specificity of 92.84 %, and a speedup factor of 1.56× with respect to classic region growing implementations (average values).
authors.affiliation: Istituto di Bioimmagini e Fisiologia Molecolare - Consiglio Nazionale delle Ricerche (IBFM-CNR - LATO), Contrada Pietrapollastra-Pisciotto, 90015, Cefalù, PA, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Rundo
authors.affiliation: Istituto di Bioimmagini e Fisiologia Molecolare - Consiglio Nazionale delle Ricerche (IBFM-CNR - LATO), Contrada Pietrapollastra-Pisciotto, 90015, Cefalù, PA, Italy. carmelo.militello@ibfm.cnr.it.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Militello
authors.affiliation: Dipartimento di Biopatologia e Biotecnologie Mediche (DIBIMED), Università degli Studi di Palermo, Via del Vespro 129, 90127, Palermo, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Vitabile
authors.affiliation: Istituto di Bioimmagini e Fisiologia Molecolare - Consiglio Nazionale delle Ricerche (IBFM-CNR - LATO), Contrada Pietrapollastra-Pisciotto, 90015, Cefalù, PA, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Casarino
authors.affiliation: Istituto di Bioimmagini e Fisiologia Molecolare - Consiglio Nazionale delle Ricerche (IBFM-CNR - LATO), Contrada Pietrapollastra-Pisciotto, 90015, Cefalù, PA, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Russo
authors.affiliation: Dipartimento di Biopatologia e Biotecnologie Mediche (DIBIMED), Università degli Studi di Palermo, Via del Vespro 129, 90127, Palermo, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Midiri
authors.affiliation: Istituto di Bioimmagini e Fisiologia Molecolare - Consiglio Nazionale delle Ricerche (IBFM-CNR - LATO), Contrada Pietrapollastra-Pisciotto, 90015, Cefalù, PA, Italy.
authors.forename: Maria Carla
authors.initials: MC
authors.lastname: Gilardi
mesh_terms: D000465:Algorithms; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007889:Leiomyoma / Q000000981:diagnostic imaging* / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*
keywords: Automatic segmentation; MRgFUS treatments; Multi-seed adaptive region growing; Split-and-merge segmentation; Uterine fibroids