Medical imaging technologies have allowed for in vivo exploration and evaluation of the human musculoskeletal system. Three-dimensional
bone models generated using image-segmentation techniques provide a means to optimize individualized orthopedic surgical procedures
using engineering analyses. However, many of the current segmentation techniques are not clinically practical due to the required
time and human intervention. As a proof of concept, we demonstrate the use of an expectation maximization (EM) algorithm to
segment the hand phalanx bones, and hypothesize that this semi-automated technique will improve the efficiency while providing
similar definitions as compared to a manual rater. Our results show a relative overlap of the proximal, middle, and distal
phalanx bones of 0.83, 0.79, and 0.72 for the EM technique when compared to validated manual segmentations. The EM segmentations
were also compared to 3D surface scans of the cadaveric specimens, which resulted in distance maps showing an average distance
for the proximal, middle, and distal phalanx bones of 0.45, 0.46, and 0.51 mm, respectively. The EM segmentation improved
on the segmentation speed of the manual techniques by a factor of eight. Overall, the manual segmentations had greater relative
overlap metric values, which suggests that the manual segmentations are a better fit to the actual surface of the bone. As
shown by the comparison to the bone surface scans, the EM technique provides a similar representation of the anatomic structure
and offers an increase in efficiency that could help to reduce the time needed for defining anatomical structures from CT
scans.
Key words 3D Segmentation - bone - hand - computed tomography - artificial neural network