A New 3D Segmentation Technique for QCT Scans of the Lumbar Spine to Determine BMD and Vertebral Geometry

Quantitative computed tomography (QCT) is a standard method to determine bone mineral density (BMD) in the spine. Traditionally single 8 - 10 mm thick slices have been analyzed only. Current spiral CT scanners provide true 3D acquisition schemes allowing for a more differential BMD analysis and an assessment of geometric parameters, which may improve fracture prediction. We developed a novel 3D segmentation approach that combines deformable balloons, multi seeded volume growing, and dedicated morphological operations to extract the vertebral bodies. An anatomy-oriented coordinate system attached automatically to each vertebra is used to define volumes of interest. We analyzed intra-operator precision of the segmentation procedure using abdominal scans from 10 patients (60 mAs, 120 kV, slice thickness 1mm, B40s, Siemens Sensation 16). Our new segmentation method shows excellent precision errors in the order of < 1 % for BMD and < 2 % for volume.