Automated Segmentation of the Median Nerve in the Carpal Tunnel using U-Net.

Journal: Ultrasound in medicine & biology
Published Date:

Abstract

Nerve area and motion in carpal tunnel syndrome (CTS) are currently under investigation in terms of prognostic potential. Therefore, there is increasing interest in non-invasive measurement of the nerve using ultrasound. Manual segmentation is time consuming and subject to inter-rater variation, providing an opportunity for automation. Dynamic ultrasound images (n = 5560) of carpal tunnels from 99 clinically diagnosed CTS patients were used to train a U-Net-shaped neural network. The best results from the U-Net were achieved with a location primer as initial region of interest for the segmentations during finger flexion (Dice coefficient = 0.88). This is comparable to the manual Dice measure of 0.92 and higher than the resulting automated Dice measure of wrist flexion (0.81). Although there is a dependency on image quality, a trained U-Net can reliably be used in the assessment of ultrasound-acquired median nerve size and mobility, considerably decreasing manual effort.

Authors

  • Raymond T Festen
    Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Verena J M M Schrier
    Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA; Department of Plastic, Reconstructive and Hand Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
  • Peter C Amadio
    Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: pamadio@mayo.edu.