Multi-Atlas Segmentation with Joint Label Fusion of Osteoporotic Vertebral Compression Fractures on CT

The precise and accurate segmentation of the vertebral column is essential in the diagnosis and treatment of various orthopedic, neurological, and oncological traumas and pathologies. Segmentation is especially challenging in the presence of pathology such as vertebral compression fractures. In this paper, we propose a method to produce segmentations for osteoporotic compression fractured vertebrae by applying a multi-atlas joint label fusion technique for clinical CT images. A total of 170 thoracic and lumbar vertebrae were evaluated using atlases from five patients with varying degrees of spinal degeneration. In an osteoporotic cohort of bundled atlases, registration provided an average Dice coefficient and mean absolute surface distance of 2.7$\pm$4.5% and 0.32$\pm$0.13mm for osteoporotic vertebrae, respectively, and 90.9$\pm$3.0% and 0.36$\pm$0.11mm for compression fractured vertebrae.