Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Jun 01, 2021)
Date Submitted: Mar 4, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A Fully Automatic Deep Learning System for L3 Slice Selection and Body Composition Assessment on Abdominal Computed Tomography.
ABSTRACT
Background:
As sarcopenia research has been gaining emphasis, the need for quantification of abdominal muscle on computed tomography (CT) is increasing. Thus, a fully automated system to select L3 slice and segment muscle in an end-to-end manner is demanding.
Objective:
We aimed to develop a deep learning model (DLM) to select the L3 slice with consideration of anatomic variations and to segment cross-sectional areas (CSAs) of abdominal muscle and fat.
Methods:
Our DLM, named L3SEG-net, was composed of a YOLOv3-based algorithm for selecting the L3 slice and a fully convolutional network (FCN)-based algorithm for segmentation. The YOLOv3-based algorithm was developed via supervised learning using a training dataset (n=922), and the FCN-based algorithm was transferred from prior work. Our L3SEG-net was validated with internal (n=496) and external validation (n=586) datasets. L3 slice selection accuracy was evaluated by the distance difference between ground truths and DLM-derived results. Technical success for L3 slice selection was defined when the distance difference was <10 mm. Overall segmentation accuracy was evaluated by CSA error. The influence of anatomic variations on DLM performance was evaluated.
Results:
In the internal and external validation datasets, the accuracy of automatic L3 slice selection was high, with mean distance differences of 3.7±8.4 mm and 4.1±8.3 mm, respectively, and with technical success rates of 93.1% and 92.3%, respectively. However, in the subgroup analysis of anatomic variations, the L3 slice selection accuracy decreased, with distance differences of 12.4±15.4 mm and 12.1±14.6 mm, respectively, and with technical success rates of 67.2% and 67.9%, respectively. The overall segmentation accuracy of abdominal muscle areas was excellent regardless of anatomic variation, with the CSA errors of 1.38–3.10 cm2.
Conclusions:
A fully automatic system was developed for the selection of an exact axial CT slice at the L3 vertebral level and the segmentation of abdominal muscle areas.
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