Segmentation of Uterus Using Laparoscopic Ultrasound by an Image-Based Active Contour Approach for Guiding Gynecological Diagnosis and Surgery

PLoS One. 2015 Oct 30;10(10):e0141046. doi: 10.1371/journal.pone.0141046. eCollection 2015.

Abstract

In laparoscopic gynecologic surgery, ultrasound has been typically implemented to diagnose urological and gynecological conditions. We applied laparoscopic ultrasonography (using Esaote 7.5~10MHz laparoscopic transducer) on the retrospective analyses of 42 women subjects during laparoscopic extirpation and excision of gynecological tumors in our hospital from August 2011 to August 2013. The objective of our research is to develop robust segmentation technique for isolation and identification of the uterus from the ultrasound images, so as to assess, locate and guide in removing the lesions during laparoscopic operations. Our method enables segmentation of the uterus by the active contour algorithm. We evaluated 42 in-vivo laparoscopic images acquired from the 42 patients (age 39.1 ± 7.2 years old) and selected images pertaining to 4 cases of congenital uterine malformations and 2 cases of pelvic adhesions masses. These cases (n = 6) were used for our uterus segmentation experiments. Based on them, the active contour method was compared with the manual segmentation method by a medical expert using linear regression and the Bland-Altman analysis (used to measure the correlation and the agreement). Then, the Dice and Jaccard indices are computed for measuring the similarity of uterus segmented between computational and manual methods. Good correlation was achieved whereby 84%-92% results fall within the 95% confidence interval in the Student t-test) and we demonstrate that the proposed segmentation method of uterus using laparoscopic images is effective.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Algorithms
  • Female
  • Genital Neoplasms, Female / diagnostic imaging*
  • Genital Neoplasms, Female / surgery
  • Humans
  • Image Interpretation, Computer-Assisted / methods*
  • Laparoscopy / methods*
  • Middle Aged
  • Retrospective Studies
  • Ultrasonography
  • Urogenital Abnormalities / diagnosis*
  • Uterus / abnormalities*
  • Uterus / diagnostic imaging*
  • Uterus / pathology

Supplementary concepts

  • Uterine Anomalies

Grants and funding

This work was supported part by Grant No.201102054 from Shenzhen science and technology Bureau, and part by Grant JCYJ20140414170821285, CXZZ20140909004122087 from Shenzhen science and technology innovation Committee. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.