Automated bony region identification using artificial neural networks: reliability and validation measurements

Objective The objective was to develop tools for automating the identification of bony structures, to assess the reliability of this technique against manual raters, and to validate the resulting regions of interest against physical surface scans obtained from the same specimen. Materials and methods Artificial intelligence-based algorithms have been used for image segmentation, specifically artificial neural networks (ANNs). For this study, an ANN was created and trained to identify the phalanges of the human hand. Results The relative overlap between the ANN and a manual tracer was 0.87, 0.82, and 0.76, for the proximal, middle, and distal index phalanx bones respectively. Compared with the physical surface scans, the ANN-generated surface representations differed on average by 0.35 mm, 0.29 mm, and 0.40 mm for the proximal, middle, and distal phalanges respectively. Furthermore, the ANN proved to segment the structures in less than one-tenth of the time required by a manual rater. Conclusions The ANN has proven to be a reliable and valid means of segmenting the phalanx bones from CT images. Employing automated methods such as the ANN for segmentation, eliminates the likelihood of rater drift and inter-rater variability. Automated methods also decrease the amount of time and manual effort required to extract the data of interest, thereby making the feasibility of patient-specific modeling a reality.