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CT synthesis from MR images for orthopedic applications in the lower arm using a conditional generative adversarial network
Author(s): F. Zijlstra; K. Willemsen M.D.; M. C. Florkow; R. J. B. Sakkers M.D.; H. H. Weinans; B. C. H. van der Wal M.D.; M. van Stralen; P. R. Seevinck
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Paper Abstract

Purpose: To assess the feasibility of deep learning-based high resolution synthetic CT generation from MRI scans of the lower arm for orthopedic applications. Methods: A conditional Generative Adversarial Network was trained to synthesize CT images from multi-echo MR images. A training set of MRI and CT scans of 9 ex vivo lower arms was acquired and the CT images were registered to the MRI images. Three-fold cross-validation was applied to generate independent results for the entire dataset. The synthetic CT images were quantitatively evaluated with the mean absolute error metric, and Dice similarity and surface to surface distance on cortical bone segmentations. Results: The mean absolute error was 63.5 HU on the overall tissue volume and 144.2 HU on the cortical bone. The mean Dice similarity of the cortical bone segmentations was 0.86. The average surface to surface distance between bone on real and synthetic CT was 0.48 mm. Qualitatively, the synthetic CT images corresponded well with the real CT scans and partially maintained high resolution structures in the trabecular bone. The bone segmentations on synthetic CT images showed some false positives on tendons, but the general shape of the bone was accurately reconstructed. Conclusions: This study demonstrates that high quality synthetic CT can be generated from MRI scans of the lower arm. The good correspondence of the bone segmentations demonstrates that synthetic CT could be competitive with real CT in applications that depend on such segmentations, such as planning of orthopedic surgery and 3D printing.

Paper Details

Date Published: 15 March 2019
PDF: 7 pages
Proc. SPIE 10949, Medical Imaging 2019: Image Processing, 109491J (15 March 2019); doi: 10.1117/12.2512857
Show Author Affiliations
F. Zijlstra, Univ. Medical Ctr. Utrecht (Netherlands)
K. Willemsen M.D., Univ. Medical Ctr. Utrecht (Netherlands)
M. C. Florkow, Univ. Medical Ctr. Utrecht (Netherlands)
R. J. B. Sakkers M.D., Univ. Medical Ctr. Utrecht (Netherlands)
H. H. Weinans, Univ. Medical Ctr. Utrecht (Netherlands)
B. C. H. van der Wal M.D., Univ. Medical Ctr. Utrecht (Netherlands)
M. van Stralen, Univ. Medical Ctr. Utrecht (Netherlands)
MRIguidance B. V. (Netherlands)
P. R. Seevinck, Univ. Medical Ctr. Utrecht (Netherlands)

Published in SPIE Proceedings Vol. 10949:
Medical Imaging 2019: Image Processing
Elsa D. Angelini; Bennett A. Landman, Editor(s)

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