title: Interactive graph-cut segmentation for fast creation of finite element models from clinical ct data for hip fracture prediction.
abstract: In this study, we propose interactive graph cut image segmentation for fast creation of femur finite element (FE) models from clinical computed tomography scans for hip fracture prediction. Using a sample of N = 48 bone scans representing normal, osteopenic and osteoporotic subjects, the proximal femur was segmented using manual (gold standard) and graph cut segmentation. Segmentations were subsequently used to generate FE models to calculate overall stiffness and peak force in a sideways fall simulations. Results show that, comparable FE results can be obtained with the graph cut method, with a reduction from 20 to 2-5 min interaction time. Average differences between segmentation methods of 0.22 mm were not significantly correlated with differences in FE derived stiffness (R2= 0.08, p = 0.05) and weakly correlated to differences in FE derived peak force (R2= 0.16, p = 0.01). We further found that changes in automatically assigned boundary conditions as a consequence of small segmentation differences were significantly correlated with FE derived results. The proposed interactive graph cut segmentation software MITK-GEM is freely available online at https://simtk.org/home/mitk-gem .
authors.affiliation: a Institute of Applied Information Technology , Zurich University of Applied Sciences , Winterthur , Switzerland.
authors.forename: Yves
authors.initials: Y
authors.lastname: Pauchard
authors.affiliation: a Institute of Applied Information Technology , Zurich University of Applied Sciences , Winterthur , Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fitze
authors.affiliation: a Institute of Applied Information Technology , Zurich University of Applied Sciences , Winterthur , Switzerland.
authors.forename: Diego
authors.initials: D
authors.lastname: Browarnik
authors.affiliation: b Institute for Biomechanics , ETH Zürich , Zürich , Switzerland.|c Faculty of Industrial Engineering, Mechanical Engineering and Computer Science , School of Engineering and Natural Sciences, University of Iceland , Reykjavik , Iceland.
authors.forename: Amiraslan
authors.initials: A
authors.lastname: Eskandari
authors.affiliation: d McCaig Institute for Bone and Joint Health, Cumming School of Medicine , University of Calgary , Calgary , Canada.
authors.forename: Irene
authors.initials: I
authors.lastname: Pauchard
authors.affiliation: b Institute for Biomechanics , ETH Zürich , Zürich , Switzerland.
authors.forename: William
authors.initials: W
authors.lastname: Enns-Bray
authors.affiliation: c Faculty of Industrial Engineering, Mechanical Engineering and Computer Science , School of Engineering and Natural Sciences, University of Iceland , Reykjavik , Iceland.
authors.forename: Halldór
authors.initials: H
authors.lastname: Pálsson
authors.affiliation: e The Icelandic Heart Association Research Institute , Kopavogur , Iceland.
authors.forename: Sigurdur
authors.initials: S
authors.lastname: Sigurdsson
authors.affiliation: b Institute for Biomechanics , ETH Zürich , Zürich , Switzerland.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Ferguson
authors.affiliation: f Laboratory of Epidemiology and Population Science, Intramural Research Program , National Institute on Aging , Bethesda , Maryland.
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.affiliation: e The Icelandic Heart Association Research Institute , Kopavogur , Iceland.|g Faculty of Medicine , University of Iceland , Reykjavik , Iceland.
authors.forename: Vilmundur
authors.initials: V
authors.lastname: Gudnason
authors.affiliation: b Institute for Biomechanics , ETH Zürich , Zürich , Switzerland.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Helgason
mesh_terms: D000058:Accidental Falls; D005270:Femur Head / Q000000981:diagnostic imaging / Q000473:pathology; D020342:Finite Element Analysis; D006620:Hip Fractures / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D006621:Hip Joint; D006801:Humans; D008962:Models, Theoretical; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012984:Software; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Hip fracture prediction; clinical computed tomography; femur segmentation; image segmentation; image-based finite element modeling