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Automated Segmentation Tool for Brain Infusions.doc

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Automated Segmentation Tool for Brain Infusions

AutomatedSegmentationToolforBrainInfusions KathrynHammondRosenbluth*,FranciscoGimenez,AdrianP.Kells,ErnestoA.Salegio, GabrieleM.Mittermeyer,KevinModera,AnmolKohal,KrystofS.Bankiewicz DepartmentofNeurosurgery,UniversityofCaliforniaSanFrancisco(UCSF),SanFrancisco,California,UnitedStatesofAmerica Abstract This study presents a computational tool for auto-segmenting the distribution of brain infusions observed by magnetic resonance imaging. Clinical usage of direct infusion is increasing as physicians recognize the need to attain high drug concentrationsinthetargetstructurewithminimaloff-targetexposure.Byco-infusingaGadolinium-basedcontrastagent andvisualizingthedistributionusingreal-timeusingmagneticresonanceimaging,physicianscanmakeinformeddecisions about when to stop or adjust the infusion. However, manual segmentation of the images is tedious and affected by subjectivepreferencesforwindowlevels,imageinterpolationandpersonalbiasesaboutwheretodelineatetheedgeofthe sloped shoulder of the infusion. This study presents a computational technique that uses a Gaussian Mixture Model to efficientlyclassifypixelsasbelongingtoeitherthehigh-intensityinfusateorlow-intensitybackground.Thealgorithmwas implemented as a distributable plug-in for the widely used imaging platform OsiriXH. Four independent operators segmentedfourteenanonymizeddatasetstovalidatethetool’sperformance.Thedatasetswereintra-operativemagnetic resonanceimagesofinfusionsintothethalamusorputamenofnon-humanprimates.Thetooleffectivelyreproducedthe manualsegmentationvolumes,whilesignificantlyreducingintra-operatorvariabilityby67618%.Thetoolwillbeusedto increaseefficiencyandreducevariabilityinupcomingclinicaltrialsinneuro-oncologyandgenetherapy. Citation:RosenbluthKH,GimenezF,KellsAP,SalegioEA,MittermeyerGM,etal.(2013)AutomatedSegmentationToolforBrainInfusions.PLoSONE8(6):e64452. doi:10.1371/journal.pone.0064452 Editor:NadineGaab,BostonChildren’sHospital,UnitedStatesofAmerica ReceivedAugust7,2012;AcceptedApril12,20