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Combining split-and-merge and multi-seed region growing algorithms for uterine fibroid segmentation in MRgFUS treatments

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Abstract

Uterine fibroids are benign tumors that can affect female patients during reproductive years. Magnetic resonance-guided focused ultrasound (MRgFUS) represents a noninvasive approach that uses thermal ablation principles to treat symptomatic fibroids. During traditional treatment planning, uterus, fibroids, and surrounding organs at risk must be manually marked on MR images by an operator. After treatment, an operator must segment, again manually, treated areas to evaluate the non-perfused volume (NPV) inside the fibroids. Both pre- and post-treatment procedures are time-consuming and operator-dependent. This paper presents a novel method, based on an advanced direct region detection model, for fibroid segmentation in MR images to address MRgFUS post-treatment segmentation issues. An incremental procedure is proposed: split-and-merge algorithm results are employed as multiple seed-region selections by an adaptive region growing procedure. The proposed approach segments multiple fibroids with different pixel intensity, even in the same MR image. The method was evaluated using area-based and distance-based metrics and was compared with other similar works in the literature. Segmentation results, performed on 14 patients, demonstrated the effectiveness of the proposed approach showing a sensitivity of 84.05 %, a specificity of 92.84 %, and a speedup factor of 1.56× with respect to classic region growing implementations (average values).

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Acknowledgments

This work was supported by “Development of a New Technological Platform Based on Focused Ultrasounds for Non Invasive Treatment of Tumors and Infections” project (PON 01_01059) and by “Smart Health 2.0” MIUR project (PON 04a2_C).

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Correspondence to Carmelo Militello.

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Rundo, L., Militello, C., Vitabile, S. et al. Combining split-and-merge and multi-seed region growing algorithms for uterine fibroid segmentation in MRgFUS treatments. Med Biol Eng Comput 54, 1071–1084 (2016). https://doi.org/10.1007/s11517-015-1404-6

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  • DOI: https://doi.org/10.1007/s11517-015-1404-6

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