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- Jesse A M van Doormaal, Tim Fick, Meedie Ali, Mare Köllen, Vince van der Kuijp, and van DoormaalTristan P CTPCDepartment of Neurosurgery, University Medical Center Utrecht, Utrecht, Province of Utrecht, the Netherlands; Department of Neurosurgery, University Hospital of Zürich, Zürich, Canton of Zürich, Switzerland..
- Department of Neurosurgery, University Medical Center Utrecht, Utrecht, Province of Utrecht, the Netherlands. Electronic address: Jessevandoormaal@gmail.com.
- World Neurosurg. 2021 Dec 1; 156: e9-e24.
ObjectiveEffective image segmentation of cerebral structures is fundamental to 3-dimensional techniques such as augmented reality. To be clinically viable, segmentation algorithms should be fully automatic and easily integrated in existing digital infrastructure. We created a fully automatic adaptive-meshing-based segmentation system for T1-weighted magnetic resonance images (MRI) to automatically segment the complete ventricular system, running in a cloud-based environment that can be accessed on an augmented reality device. This study aims to assess the accuracy and segmentation time of the system by comparing it to a manually segmented ground truth dataset.MethodsA ground truth (GT) dataset of 46 contrast-enhanced and non-contrast-enhanced T1-weighted MRI scans was manually segmented. These scans also were uploaded to our system to create a machine-segmented (MS) dataset. The GT data were compared with the MS data using the Sørensen-Dice similarity coefficient and 95% Hausdorff distance to determine segmentation accuracy. Furthermore, segmentation times for all GT and MS segmentations were measured.ResultsAutomatic segmentation was successful for 45 (98%) of 46 cases. Mean Sørensen-Dice similarity coefficient score was 0.83 (standard deviation [SD] = 0.08) and mean 95% Hausdorff distance was 19.06 mm (SD = 11.20). Segmentation time was significantly longer for the GT group (mean = 14405 seconds, SD = 7089) when compared with the MS group (mean = 1275 seconds, SD = 714) with a mean difference of 13,130 seconds (95% confidence interval 10,130-16,130).ConclusionsThe described adaptive meshing-based segmentation algorithm provides accurate and time-efficient automatic segmentation of the ventricular system from T1 MRI scans and direct visualization of the rendered surface models in augmented reality.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.
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