Accurate segmentation of connective soft tissues is still a challenging task, which hinders the generation of corresponding geometric models for biomechanical computations. Alternatively, one could predict ligament insertion sites and then approximate the shapes, based on anatomical knowledge and morphological studies. Here, we describe a corresponding integrated framework for the automatic modelling of human musculoskeletal ligaments. We combine statistical shape modelling with geometric algorithms to automatically identify insertion sites, based on which geometric surface and volume meshes are created. For demonstrating a clinical use case, the framework has been applied to generate models of the interosseous membrane in the forearm. For the adoption to the forearm anatomy, ligament insertion sites in the statistical model were defined according to anatomical predictions following an approach proposed in prior work. For evaluation we compared the generated sites, as well as the ligament shapes, to data obtained from a cadaveric study, involving five forearms with a total of 15 ligaments. Our framework permitted the creation of 3D models approximating ligaments' shapes with good fidelity. However, we found that the statistical model trained with the state-of-the-art prediction of the insertion sites was not always reliable. Using that model, average mean square errors as well as Hausdorff distances of the meshes increased by more than one order of magnitude, as compared to employing the known insertion locations of the cadaveric study. Using the latter an average mean square error of 0.59 mm and an average Hausdorff distance of less than 7 mm resulted, for the complete set of ligaments. In conclusion, the presented approach for generating ligament shapes from insertion points appears to be feasible but the detection of the insertion sites with a SSM is too inaccurate. For this part, another more patient-specific approach should be followed.
BACKGROUND: Accurate segmentation of connective soft tissues in medical images is very challenging, hampering the generation of geometric models for bio-mechanical computations. Alternatively, one could predict ligament insertion sites and then approximate the shapes, based on anatomical knowledge and morphological studies. OBJECTIVE: In this work, we describe an integrated framework for automatic modelling of human musculoskeletal ligaments. METHOD: We combine statistical shape modelling with geometric algorithms to automatically identify insertion sites, based on which geometric surface/volume meshes are created. As clinical use case, the framework has been applied to generate models of the forearm interosseous membrane. Ligament insertion sites in the statistical model were defined according to anatomical predictions following a published approach. RESULTS: For evaluation we compared the generated sites, as well as the ligament shapes, to data obtained from a cadaveric study, involving five forearms with 15 ligaments. Our framework permitted the creation of models approximating ligaments’ shapes with good fidelity. However, we found that the statistical model trained with the state-of-the-art prediction of the insertion sites was not always reliable. Average mean square errors as well as Hausdorff distances of the meshes could increase by an order of magnitude, as compared to employing known insertion locations of the cadaveric study. Using those, an average mean square error of 0.59 mm and an average Hausdorff distance of less than 7 mm resulted, for all ligaments. CONCLUSIONS: The presented approach for automatic generation of ligament shapes from insertion points appears to be feasible but the detection of the insertion sites with a SSM is too inaccurate, thus making a patient-specific approach necessary.
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