Fully automatic algorithm for segmenting full human diaphragm in non-contrast CT Images

The diaphragm is a sheet of muscle which separates the thorax from the abdomen and it acts as the most important muscle of the respiratory system. As such, an accurate segmentation of the diaphragm, not only provides key information for functional analysis of the respiratory system, but also can be used for locating other abdominal organs such as the liver. However, diaphragm segmentation is extremely challenging in non-contrast CT images due to the diaphragm's similar appearance to other abdominal organs. In this paper, we present a fully automatic algorithm for diaphragm segmentation in non-contrast CT images. The method is mainly based on a priori knowledge about the human diaphragm anatomy. The diaphragm domes are in contact with the lungs and the heart while its circumference runs along the lumbar vertebrae of the spine as well as the inferior border of the ribs and sternum. As such, the diaphragm can be delineated by segmentation of these organs followed by connecting relevant parts of their outline properly. More specifically, the bottom surface of the lungs and heart, the spine borders and the ribs are delineated, leading to a set of scattered points which represent the diaphragm's geometry. Next, a B-spline filter is used to find the smoothest surface which pass through these points. This algorithm was tested on a noncontrast CT image of a lung cancer patient. The results indicate that there is an average Hausdorff distance of 2.96 mm between the automatic and manually segmented diaphragms which implies a favourable accuracy.