Development of a fully automatic shape model matching (FASMM) system to derive statistical shape models from radiographs: application to the accurate.

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Development of a fully automatic shape model matching (FASMM) system to derive statistical shape models from radiographs: application to the accurate capture and global representation of proximal femur shape C. Lindner, S. Thiagarajah, J.M. Wilkinson, G.A. Wallis, T.F. Cootes Osteoarthritis and Cartilage Volume 21, Issue 10, Pages 1537-1544 (October 2013) DOI: 10.1016/j.joca.2013.08.008 Copyright © 2013 Osteoarthritis Research Society International Terms and Conditions

Fig. 1 Fully automatic segmentation of the proximal femur: Detecting the proximal femur in the image (left) and outlining its contour using 65 points (right). All anchor points are highlighted in red and were chosen to mark the following features: the beginning (point 3) and the end (point 10) of the lesser trochanter projected to the nearby femoral shaft contour, inflexion points at the inferior (point 17) and superior (point 38) femoral head–neck junction, the inferior (point 20) and superior (point 35) end of the hemispheric femoral head shape, the projected beginning of the trochanteric fossa (point 44) as well as local maxima at the superior contour of the greater trochanter (point 48) and at the inferior end of the greater trochanter (point 55). Note that these features are based on the visual appearance of the proximal femur in AP pelvic radiographs; this does not necessarily correspond with three-dimensional anatomical features. Osteoarthritis and Cartilage 2013 21, 1537-1544DOI: (10.1016/j.joca.2013.08.008) Copyright © 2013 Osteoarthritis Research Society International Terms and Conditions

Fig. 2 Geometric measurements based on output of the FASMM system: FHD, FNAL, FNW, FNSA, AA. Note that the fully automatic calculation of these measurements is based on the blue contour points only whereas the fully automatic prediction uses an SSM that includes all 65 contour points. Osteoarthritis and Cartilage 2013 21, 1537-1544DOI: (10.1016/j.joca.2013.08.008) Copyright © 2013 Osteoarthritis Research Society International Terms and Conditions

Fig. 3 Bland–Altman plots for manual measurements vs fully automatic measurements (cc = Pearson's correlation coefficient): These data show high correlation and less than 10% difference between the methods (red dotted line labelled ±2 SD, indicating limits of agreement between methods), and minimal bias (red dotted lines indicating 95% confidence interval (CI) of mean) for all but the alpha angle. Osteoarthritis and Cartilage 2013 21, 1537-1544DOI: (10.1016/j.joca.2013.08.008) Copyright © 2013 Osteoarthritis Research Society International Terms and Conditions

Fig. 4 Bland–Altman plots for manual measurements vs prediction using linear regression based on shape model mode values (cc = Pearson's correlation coefficient): These data show high correlation and less than 10% difference between the methods (red dotted line labelled ±2 SD, indicating limits of agreement between methods), and minimal bias (red dotted lines indicating 95% CI of mean) for all but the alpha angle. Osteoarthritis and Cartilage 2013 21, 1537-1544DOI: (10.1016/j.joca.2013.08.008) Copyright © 2013 Osteoarthritis Research Society International Terms and Conditions

Fig. 5 Shape differences between male () and female () proximal femur shape based on fully automatic search results for 1105 images, where differences from the mean () have been exaggerated by a factor of 3 to aid visualisation. Osteoarthritis and Cartilage 2013 21, 1537-1544DOI: (10.1016/j.joca.2013.08.008) Copyright © 2013 Osteoarthritis Research Society International Terms and Conditions