Abstract
BACKGROUND: The shape, size, and surface information relating to the glenoid fossae and condyles in temporomandibular joints (TMJ) are essential for diagnosing and treating. Patients with TMJ disease often have surface abrasion which may cause fuzzy edges in computed tomography (CT) imaging, especially for low-dose CT, making TMJ segmentation more difficult. METHODS: In this paper, an automatic segmentation algorithm based on deep learning and post-processing was introduced. First, U-Net was used to divide images into 3 categories: glenoid fossae, condyles, and background. For structural fractures in these divided images, the internal force constraint of a snake model was used to replenish the integrity of the fracture boundary in a post-processing operation, and the initial boundary of the snake was obtained based on the basis of the tracking concept. A total of 206 cases of low-dose CT were used to verify the effectiveness of the algorithm, and such indicators as the Dice coefficient (DC) and mean surface distance (MSD) were used to evaluate the agreement between experimental results and the gold standard. RESULTS: The proposed method is tested on a self-collected dataset. The results demonstrate that proposed method achieves state-of-the-art performance in terms of DCs = 0.92±0.03 (condyles) and 0.90±0.04 (glenoid fossae), and MSDs =0.20±0.19 mm (condyles) and 0.19±0.08 mm (glenoid fossae). CONCLUSIONS: This study is the first to focus on the simultaneous segmentation of TMJ glenoid fossae and condyles. The proposed U-Net + tracking-based algorithm showed a relatively high segmentation efficiency, enabling it to achieve sought-after segmentation accuracy.