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We propose a methodology to aid clinicians in performing lumbar spinal stenosis detection through semantic segmentation and delineation of magnetic resonance imaging (MRI) scans of the lumbar spine using deep learning. Our dataset contains MRI studies of 515 patients with symptomatic back pains. Each study is annotated by expert radiologists with notes regarding the observed characteristics and condition of the lumbar spine. We have developed a ground truth dataset, containing image labels of four important regions in the lumbar spine, to be used as the training and test images to develop classification models for segmentation. We developed two novel metrics, namely confidence, and consistency, to assess the quality of the ground truth dataset through a derivation of the Jaccard Index. We experimented with semantic segmentation of our dataset using SegNet. Our evaluation of the segmentation and the delineation results show that our proposed methodology produces a very good performance as measured by several contour-based and region-based metrics. In addition, using the Cohen's kappa and frequency-weighted confidence metrics, we can show that 1) the model's performance is within the range of the worst and the best manual labeling results and 2) the ground-truth dataset has an excellent inter-rater agreement score. We also presented two representative delineation results of the worst and best segmentation based on their BF-score to show visually how accurate and suitable the results are for computer-aided-diagnosis purposes.
Kafri et al. (Tue,) studied this question.