Learning Based Segmentation of CT Brain Images: Application to Post-Operative Hydrocephalic Scans

Objective: Hydrocephalus is a medical condition in which there is an abnormal accumulation of cerebrospinal fluid (CSF) in the brain. Segmentation of brain imagery into brain tissue and CSF (before and after surgery, i.e. pre-op vs. postop) plays a crucial role in evaluating surgical treatment. Segmentation of pre-op images is often a relatively straightforward problem and has been well researched. However, segmenting post-operative (post-op) computational tomographic (CT)-scans becomes more challenging due to distorted anatomy and subdural hematoma collections pressing on the brain. Most intensity and feature based segmentation methods fail to separate subdurals from brain and CSF as subdural geometry varies greatly across different patients and their intensity varies with time. We combat this problem by a learning approach that treats segmentation as supervised classification at the pixel level, i.e. a training set of CT scans with labeled pixel identities is employed. Methods: Our contributions include: 1.) a dictionary learning framework that learns class (segment) specific dictionaries that can efficiently represent test samples from the same class while poorly represent corresponding samples from other classes, 2.) quantification of associated computation and memory footprint, and 3.) a customized training and test procedure for segmenting post-op hydrocephalic CT images. Results: Experiments performed on infant CT brain images acquired from the CURE Children's Hospital of Uganda reveal the success of our method against the state-of-the-art alternatives. We also demonstrate that the proposed algorithm is computationally less burdensome and exhibits a graceful degradation against number of training samples, enhancing its deployment potential. IEEE Transactions on Biomedical Engineering, 2018