A pipeline to quantify spinal cord atrophy with deep learning: Application to differentiation of MS and NMOSD patients

A B S T R A C T
Purpose: Quantitative measurement of various anatomical regions of the brain and spinal cord (SC) in MRI images
are used as unique biomarkers to consider progress and effects of demyelinating diseases of the central nervous
system. This paper presents a fully-automated image processing pipeline which quantifies the SC volume of MRI
images.
Methods: In the proposed pipeline, after conducting some pre-processing tasks, a deep convolutional network is
utilized to segment the spinal cord cross-sectional area (SCCSA) of each slice. After full segmentation, certain
extra slices interpolate between each two adjacent slices using the shape-based interpolation method. Then, a 3D
model of the SC is reconstructed, and, by counting the voxels of it, the SC volume is calculated. The performance
of the proposed method for the SCCSA segmentation is evaluated on 140 MRI images. Subsequently, to
demonstrate the application of the proposed pipeline, we study the differentiations of SC atrophy between 38
Multiple Sclerosis (MS) and 25 Neuromyelitis Optica Spectrum Disorder (NMOSD) patients.
Results: The experimental results of the SCCSA segmentation indicate that the proposed method, adapted by Mask
R-CNN, presented the most satisfactory result with the average Dice coefficient of 0.96. For this method, statistical
metrics including sensitivity, specificity, accuracy, and precision are 97.51%, 99.98%, 99.92%, and
98.04% respectively. Moreover, the t-test result (p-value = 0.00089) verified a significant difference between the
SC atrophy of MS and NMOSD patients.
Conclusion: The pipeline efficiently quantifies the SC volume of MRI images and can be utilized as an affordable
computer-aided tool for diagnostic purposes.