将MRI分析流程扩展到CT,实现脑部CT的自动分割与体积测量。
CTseg: A Tool for Brain CT Segmentation, Spatial Normalisation, and Volumetrics

- 基于Multi-Brain框架构建专用于CT的分割与配准流程
- 在四维评估中显著优于直接用MRI方法处理CT数据
- 适合临床研究中需快速分析脑部CT的科研人员
本文介绍并验证了CTseg,一款免费开源的脑部CT分割、空间配准和体积测量软件。CTseg基于Multi-Brain生成建模框架,提供针对CT的专用处理流程,生成组织图、形变场和脑体积估计值,格式与SPM统一分割一致,从而将SPM成熟的分析链从MRI拓展至CT。CTseg设计用于常规医院头颅CT扫描,部署时无需预处理或重采样。尽管已在卒中、痴呆和脑形态学等临床研究中被采用,但缺乏独立金标准的系统验证。利用配对的MR/CT头像,我们在四个维度评估CTseg:以MRI导出的银标准为基准的分割精度;通过群体平均锐度和体素级变异系数评估的空间配准一致性;通过组内相关系数和Bland-Altman分析检验的脑体积一致性;以及从配准组织图中进行性别分类的下游性能。作为基线,我们将SPM的MRI统一分割直接应用于CT图像。结果表明,CTseg在分割与配准上显著优于基线,脑总容积(TBV)一致性更强,总体积(TIV)一致性相当。CTseg可免费获取(https://github.com/WCHN/CTseg),所有实验代码均包含于仓库中,确保完全可复现。
原文摘要 · Abstract (English)
This paper presents and validates CTseg, a freely available software for brain CT segmentation, spatial normalisation, and volumetrics. CTseg builds on the Multi-Brain generative modelling framework, providing a CT-specific pipeline that produces tissue maps, deformation fields, and brain volume estimates in the same format as SPM's unified segmentation, thereby extending SPM's established analysis chain from MRI to CT. CTseg is designed for routine hospital CT scans without requiring preprocessing or resampling in deployment. Although CTseg has been adopted in clinical research spanning, among other things, stroke, dementia, and brain morphometry, a systematic validation against an independent reference standard has been lacking. Using paired MR/CT head scans, we evaluate CTseg across four dimensions: segmentation accuracy against an MRI-derived silver standard; spatial normalisation consistency through group-average sharpness and voxelwise coefficient of variation; brain volume agreement via intraclass correlation and Bland-Altman analysis; and downstream sex classification performance from normalised tissue maps. As a baseline, we apply SPM's MRI-based unified segmentation directly to the CT images. CTseg significantly outperformed this baseline for segmentation and normalisation, showed stronger TBV agreement, and achieved comparable TIV agreement. CTseg is freely available at https://github.com/WCHN/CTseg, and all experiment code is included in the repository for full reproducibility.
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