A pilot study for segmentation of pharyngeal and sino-nasal airway subregions by automatic contour initialization.

PURPOSE: The objective of the present study is to put forward a novel automatic segmentation algorithm to segment pharyngeal and sino-nasal airway subregions on 3D CBCT imaging datasets.

METHODS: A fully automatic segmentation of sino-nasal and pharyngeal airway subregions was implemented in MATLAB programing environment. The novelty of the algorithm is automatic initialization of contours in upper airway subregions. The algorithm is based on boundary definitions of the human anatomy along with shape constraints with an automatic initialization of contours to develop a complete algorithm which has a potential to enhance utility at clinical level. Post-initialization; five segmentation techniques: Chan-Vese level set (CVL), localized Chan-Vese level set (LCVL), Bhattacharya distance level set (BDL), Grow Cut (GC), and Sparse Field method (SFM) were used to test the robustness of automatic initialization.

RESULTS: Precision and F-score were found to be greater than 80% for all the regions with all five segmentation methods. High precision and low recall were observed with BDL and GC techniques indicating an under segmentation. Low precision and high recall values were observed with CVL and SFM methods indicating an over segmentation. A Larger F-score value was observed with SFM method for all the subregions. Minimum F-score value was observed for naso-ethmoidal and sphenoidal air sinus region, whereas a maximum F-score was observed in maxillary air sinuses region. The contour initialization was more accurate for maxillary air sinuses region in comparison with sphenoidal and naso-ethmoid regions.

CONCLUSION: The overall F-score was found to be greater than 80% for all the airway subregions using five segmentation techniques, indicating accurate contour initialization. Robustness of the algorithm needs to be further tested on severely deformed cases and on cases with different races and ethnicity for it to have global acceptance in Katradental radKatraiology workflow.