Skip to main content
Erschienen in: European Spine Journal 9/2016

07.07.2016 | Original Article

Intervertebral disc classification by its degree of degeneration from T2-weighted magnetic resonance images

verfasst von: Isaac Castro-Mateos, Rui Hua, Jose M. Pozo, Aron Lazary, Alejandro F. Frangi

Erschienen in: European Spine Journal | Ausgabe 9/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The primary goal of this article is to achieve an automatic and objective method to compute the Pfirrmann’s degeneration grade of intervertebral discs (IVD) from MRI. This grading system is used in the diagnosis and management of patients with low back pain (LBP). In addition, biomechanical models, which are employed to assess the treatment on patients with LBP, require this grading value to compute proper material properties.

Materials and methods

T2-weighted MR images of 48 patients were employed in this work. The 240 lumbar IVDs were divided into a training set (140) and a testing set (100). Three experts manually classified the whole set of IVDs using the Pfirrmann’s grading system and the ground truth was selected as the most voted value among them. The developed method employs active contour models to delineate the boundaries of the IVD. Subsequently, the classification is achieved using a trained Neural Network (NN) with eight designed features that contain shape and intensity information of the IVDs.

Results

The classification method was evaluated using the testing set, resulting in a mean specificity (95.5 %) and sensitivity (87.3 %) comparable to those of every expert with respect to the ground truth.

Conclusions

Our results show that the automatic method and humans perform equally well in terms of the classification accuracy. However, human annotations have inherent inter- and intra-observer variabilities, which lead to inconsistent assessments. In contrast, the proposed automatic method is objective, being only dependent on the input MRI.
Literatur
1.
Zurück zum Zitat Sharan AD, Tang Simon Y, Vaccaro AR (2013) Basic science of spinal diseases. JP Medical Ltd, New DelhiCrossRef Sharan AD, Tang Simon Y, Vaccaro AR (2013) Basic science of spinal diseases. JP Medical Ltd, New DelhiCrossRef
2.
Zurück zum Zitat Freemont A, Watkins A, Le Maitre C, Jeziorska M, Hoyland J (2002) Current understanding of cellular and molecular events in intervertebral disc degeneration: implications for therapy. J Pathol 196(4):374–379CrossRefPubMed Freemont A, Watkins A, Le Maitre C, Jeziorska M, Hoyland J (2002) Current understanding of cellular and molecular events in intervertebral disc degeneration: implications for therapy. J Pathol 196(4):374–379CrossRefPubMed
3.
Zurück zum Zitat Malandrino A, Pozo JM, Castro-Mateos I, Frangi AF, van Rijsbergen MM, Ito K, Wilke HJ, Dao TT, Tho MCHB, Noailly J (2015) On the relative relevance of subjectspecific geometries and degeneration-specific mechanical properties for the study of cell death in human intervertebral disk models. Front Bioeng Biotechnol 3(5) Malandrino A, Pozo JM, Castro-Mateos I, Frangi AF, van Rijsbergen MM, Ito K, Wilke HJ, Dao TT, Tho MCHB, Noailly J (2015) On the relative relevance of subjectspecific geometries and degeneration-specific mechanical properties for the study of cell death in human intervertebral disk models. Front Bioeng Biotechnol 3(5)
4.
Zurück zum Zitat Luoma K, Riihimaki H, Luukkonen R, Raininko R, Viikari-Juntura E, Lamminen A (2000) Low back pain in relation to lumbar disc degeneration. Spine 25(4):487–492CrossRefPubMed Luoma K, Riihimaki H, Luukkonen R, Raininko R, Viikari-Juntura E, Lamminen A (2000) Low back pain in relation to lumbar disc degeneration. Spine 25(4):487–492CrossRefPubMed
5.
Zurück zum Zitat Livshits G, Popham M, Malkin I, Sambrook PN, Macgregor AJ, Spector T, Williams FMK (2011) Lumbar disc degeneration and genetic factors are the main risk factors for low back pain in women: the UK twin spine study. Ann Rheum Dis 70(10):1740–1745CrossRefPubMedPubMedCentral Livshits G, Popham M, Malkin I, Sambrook PN, Macgregor AJ, Spector T, Williams FMK (2011) Lumbar disc degeneration and genetic factors are the main risk factors for low back pain in women: the UK twin spine study. Ann Rheum Dis 70(10):1740–1745CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Fujiwara A, Tamai K, Yamato M, An HS, Yoshida H, Saotome K, Kurihashi A (1999) The relationship between facet joint osteoarthritis and disc degeneration of the lumbar spine: an MRI study. Eur Spine J 8(5):396–401CrossRefPubMedPubMedCentral Fujiwara A, Tamai K, Yamato M, An HS, Yoshida H, Saotome K, Kurihashi A (1999) The relationship between facet joint osteoarthritis and disc degeneration of the lumbar spine: an MRI study. Eur Spine J 8(5):396–401CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Thompson J, Pearce R, Schechter M, Adams M, Tsang I, Bishop P (1990) Preliminary evaluation of a scheme for grading the gross morphology of the human intervertebral disc. Spine 15(5):411–415CrossRefPubMed Thompson J, Pearce R, Schechter M, Adams M, Tsang I, Bishop P (1990) Preliminary evaluation of a scheme for grading the gross morphology of the human intervertebral disc. Spine 15(5):411–415CrossRefPubMed
8.
Zurück zum Zitat Pfirrmann C, Metzdorf A, Zanetti M, Hodler J, Boos N (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26:1873–1878CrossRefPubMed Pfirrmann C, Metzdorf A, Zanetti M, Hodler J, Boos N (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26:1873–1878CrossRefPubMed
9.
Zurück zum Zitat Jarman JP, Arpinar VE, Baruah D, Klein AP, Maiman DJ, Muftuler LT (2014) Intervertebral disc height loss demonstrates the threshold of major pathological changes during degeneration. Eur Spine J 1–7 Jarman JP, Arpinar VE, Baruah D, Klein AP, Maiman DJ, Muftuler LT (2014) Intervertebral disc height loss demonstrates the threshold of major pathological changes during degeneration. Eur Spine J 1–7
10.
Zurück zum Zitat Riesenburger RI, Safain MG, Ogbuji R, Hayes J, Hwang SW (2015) A novel classification system of lumbar disc degeneration. J Clin Neurosci 22(2):346–351CrossRefPubMed Riesenburger RI, Safain MG, Ogbuji R, Hayes J, Hwang SW (2015) A novel classification system of lumbar disc degeneration. J Clin Neurosci 22(2):346–351CrossRefPubMed
11.
Zurück zum Zitat Chwialkowski M, Shile P, Peshock R, Pfeifer D, Parkey R (1989) Automated detection and evaluation of lumbar discs in MR images. Eng Med Biol Soc 571–572 Chwialkowski M, Shile P, Peshock R, Pfeifer D, Parkey R (1989) Automated detection and evaluation of lumbar discs in MR images. Eng Med Biol Soc 571–572
12.
Zurück zum Zitat Michopoulou S, Boniatis I, Costaridou L, Cavouras D, Panagiotopoulos E, Panayiotakis G (2009) Computer assisted characterization of cervical intervertebral disc degeneration in MRI. J Instrum 4(05):P05022CrossRef Michopoulou S, Boniatis I, Costaridou L, Cavouras D, Panagiotopoulos E, Panayiotakis G (2009) Computer assisted characterization of cervical intervertebral disc degeneration in MRI. J Instrum 4(05):P05022CrossRef
13.
Zurück zum Zitat Ghosh S, Alomari R, Chaudhary V, Dhillon G (2011) Composite features for automatic diagnosis of intervertebral disc herniation from lumbar MRI. Eng Med Biol Soc EMBC 5068–5071 Ghosh S, Alomari R, Chaudhary V, Dhillon G (2011) Composite features for automatic diagnosis of intervertebral disc herniation from lumbar MRI. Eng Med Biol Soc EMBC 5068–5071
14.
Zurück zum Zitat Una lY, Kocer H, Akkurt H (2011) A comparison of feature extraction techniques for diagnosis of lumbar intervertebral degenerative disc disease. In: International Symposium on Innovations in Intelligent Systems and Applications (INISTA), pp 490–494 Una lY, Kocer H, Akkurt H (2011) A comparison of feature extraction techniques for diagnosis of lumbar intervertebral degenerative disc disease. In: International Symposium on Innovations in Intelligent Systems and Applications (INISTA), pp 490–494
15.
Zurück zum Zitat Alomari RS, Corso JJ, Chaudhary V, Dhillon G (2010) Automatic diagnosis of lumbar disc herniation with shape and appearance features from MRI. SPIE Med Imaging 76241A Alomari RS, Corso JJ, Chaudhary V, Dhillon G (2010) Automatic diagnosis of lumbar disc herniation with shape and appearance features from MRI. SPIE Med Imaging 76241A
16.
Zurück zum Zitat Neubert A, Fripp J, Engstrom C, Walker D, Weber M, Schwarz R, Crozier S (2013) Three-dimensional morphological and signal intensity features for detection of intervertebral disc degeneration from magnetic resonance images. J Am Med Inf Assoc 20(6):1082–1090 Neubert A, Fripp J, Engstrom C, Walker D, Weber M, Schwarz R, Crozier S (2013) Three-dimensional morphological and signal intensity features for detection of intervertebral disc degeneration from magnetic resonance images. J Am Med Inf Assoc 20(6):1082–1090
17.
Zurück zum Zitat Lootus M, Kadir T, Zisserman (2015) A.: automated radiological grading of spinal MRI In: recent advances in computational methods and clinical applications for spine imaging, pp 119–130 Lootus M, Kadir T, Zisserman (2015) A.: automated radiological grading of spinal MRI In: recent advances in computational methods and clinical applications for spine imaging, pp 119–130
18.
Zurück zum Zitat Ruiz-España S, Arana E, Moratal D (2015) Semiautomatic computer-aided classification of degenerative lumbar spine disease in magnetic resonance imaging. Comput Biol Med 62:196–205CrossRefPubMed Ruiz-España S, Arana E, Moratal D (2015) Semiautomatic computer-aided classification of degenerative lumbar spine disease in magnetic resonance imaging. Comput Biol Med 62:196–205CrossRefPubMed
19.
Zurück zum Zitat Castro-Mateos I, Pozo JM, Lazary A, Frangi AF (2014) 2D segmentation of intervertebral discs and its degree of degeneration from T2-weighted magnetic resonance images. SPIE Med Imaging 903517 Castro-Mateos I, Pozo JM, Lazary A, Frangi AF (2014) 2D segmentation of intervertebral discs and its degree of degeneration from T2-weighted magnetic resonance images. SPIE Med Imaging 903517
20.
Zurück zum Zitat Cannon RL, Dave JV, Bezdek JC (1986) Efficient implementation of the fuzzy c-means clustering algorithms. Pattern Anal Mach Intell IEEE Trans 2:248–255CrossRef Cannon RL, Dave JV, Bezdek JC (1986) Efficient implementation of the fuzzy c-means clustering algorithms. Pattern Anal Mach Intell IEEE Trans 2:248–255CrossRef
21.
Zurück zum Zitat Castro-Mateos I, Pozo JM, Eltes PE, Del Rio L, Lazary A, Frangi AF (2014) 3D segmentation of annulus fibrosus and nucleus pulposus from T2-weighted magnetic resonance images. Phys Med Biol 59(24):7847–7864CrossRefPubMed Castro-Mateos I, Pozo JM, Eltes PE, Del Rio L, Lazary A, Frangi AF (2014) 3D segmentation of annulus fibrosus and nucleus pulposus from T2-weighted magnetic resonance images. Phys Med Biol 59(24):7847–7864CrossRefPubMed
22.
Zurück zum Zitat Newcombe RG (1998) Two-sided confidence intervals for the single proportion: comparison of seven methods. Stat Med 17(8):857–872CrossRefPubMed Newcombe RG (1998) Two-sided confidence intervals for the single proportion: comparison of seven methods. Stat Med 17(8):857–872CrossRefPubMed
23.
Zurück zum Zitat Bera AK, Bilias Y (2001) Rao’s score, Neyman’s C(α) and Silvey’s LM tests: an essay on historical developments and some new results. J Stat Plan Inference 97(1):9–44CrossRef Bera AK, Bilias Y (2001) Rao’s score, Neyman’s C(α) and Silvey’s LM tests: an essay on historical developments and some new results. J Stat Plan Inference 97(1):9–44CrossRef
24.
Zurück zum Zitat Malandrino A, Noailly J, Lacroix D, Beard DA (2011) The effect of sustained compression on oxygen metabolic transport in the intervertebral disc decreases with degenerative changes. PLOS Comput Biol 7(8) Malandrino A, Noailly J, Lacroix D, Beard DA (2011) The effect of sustained compression on oxygen metabolic transport in the intervertebral disc decreases with degenerative changes. PLOS Comput Biol 7(8)
25.
Zurück zum Zitat Schmidt S, Bergtholdt M, Dries S, Schnorr C (2007) Spine detection and labeling using a parts-based graphical model. In: Lect Notes Comput Sc (IPMI), pp 122–133 Schmidt S, Bergtholdt M, Dries S, Schnorr C (2007) Spine detection and labeling using a parts-based graphical model. In: Lect Notes Comput Sc (IPMI), pp 122–133
26.
Zurück zum Zitat Stern D, Vrtovec T, Pernus F, Likar B (2010) Automated determination of the centers of vertebral bodies and intervertebral discs in CT and MR lumbar spine images. In: Proceedings of SPIE, pp 762350 Stern D, Vrtovec T, Pernus F, Likar B (2010) Automated determination of the centers of vertebral bodies and intervertebral discs in CT and MR lumbar spine images. In: Proceedings of SPIE, pp 762350
27.
Zurück zum Zitat Peng Z, Zhong J, Wee W, Lee JH (2005) Automated vertebra detection and segmentation from the whole spine MR images. Eng Med Biol Soc Ann IEEE-EMBS, pp 2527–2530 Peng Z, Zhong J, Wee W, Lee JH (2005) Automated vertebra detection and segmentation from the whole spine MR images. Eng Med Biol Soc Ann IEEE-EMBS, pp 2527–2530
28.
Zurück zum Zitat Corso JJ, Alomari RS, Chaudhary V (2008) Lumbar disc localization and labeling with a probabilistic model on both pixel and object features. In: Lect Notes Comput Sc (MICCAI), pp 202–210 Corso JJ, Alomari RS, Chaudhary V (2008) Lumbar disc localization and labeling with a probabilistic model on both pixel and object features. In: Lect Notes Comput Sc (MICCAI), pp 202–210
29.
Zurück zum Zitat Ellingson AM, Mehta H, Polly DW, Ellermann J, Nuckley DJ (2013) Disc degeneration assessed by quantitative T2*(T2 star) correlated with functional lumbar mechanics. Spine 38(24):E1533–E1540CrossRefPubMed Ellingson AM, Mehta H, Polly DW, Ellermann J, Nuckley DJ (2013) Disc degeneration assessed by quantitative T2*(T2 star) correlated with functional lumbar mechanics. Spine 38(24):E1533–E1540CrossRefPubMed
30.
Zurück zum Zitat Hon JY, Bahri S, Gardner V, Muftuler LT (2014) In vivo quantification of lumbar disc degeneration: assessment of ADC value using a degenerative scoring system based on Pfirrmann framework. Eur Spine J 24(11):1–7 Hon JY, Bahri S, Gardner V, Muftuler LT (2014) In vivo quantification of lumbar disc degeneration: assessment of ADC value using a degenerative scoring system based on Pfirrmann framework. Eur Spine J 24(11):1–7
Metadaten
Titel
Intervertebral disc classification by its degree of degeneration from T2-weighted magnetic resonance images
verfasst von
Isaac Castro-Mateos
Rui Hua
Jose M. Pozo
Aron Lazary
Alejandro F. Frangi
Publikationsdatum
07.07.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 9/2016
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-016-4654-6

Weitere Artikel der Ausgabe 9/2016

European Spine Journal 9/2016 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.