• Madeline Hess, Brett Allaire, Kenneth T Gao, Radhika Tibrewala, Gaurav Inamdar, Upasana Bharadwaj, Cynthia Chin, Valentina Pedoia, Mary Bouxsein, Dennis Anderson, and Sharmila Majumdar.
• Department of Radiology and Biomedical Imaging, Center for Intelligent Imaging, University of California, San Francisco, San Francisco, California.
• Pain Med. 2023 Aug 4; 24 (Suppl 1): S139S148S139-S148.

Study DesignIn vivo retrospective study of fully automatic quantitative imaging feature extraction from clinically acquired lumbar spine magnetic resonance imaging (MRI).ObjectiveTo demonstrate the feasibility of substituting automatic for human-demarcated segmentation of major anatomic structures in clinical lumbar spine MRI to generate quantitative image-based features and biomechanical models.SettingPrevious studies have demonstrated the viability of automatic segmentation applied to medical images; however, the feasibility of these networks to segment clinically acquired images has not yet been demonstrated, as they largely rely on specialized sequences or strict quality of imaging data to achieve good performance.MethodsConvolutional neural networks were trained to demarcate vertebral bodies, intervertebral disc, and paraspinous muscles from sagittal and axial T1-weighted MRIs. Intervertebral disc height, muscle cross-sectional area, and subject-specific musculoskeletal models of tissue loading in the lumbar spine were then computed from these segmentations and compared against those computed from human-demarcated masks.ResultsSegmentation masks, as well as the morphological metrics and biomechanical models computed from those masks, were highly similar between human- and computer-generated methods. Segmentations were similar, with Dice similarity coefficients of 0.77 or greater across networks, and morphological metrics and biomechanical models were similar, with Pearson R correlation coefficients of 0.69 or greater when significant.ConclusionsThis study demonstrates the feasibility of substituting computer-generated for human-generated segmentations of major anatomic structures in lumbar spine MRI to compute quantitative image-based morphological metrics and subject-specific musculoskeletal models of tissue loading quickly, efficiently, and at scale without interrupting routine clinical care.© The Author(s) 2022. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.

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