A general body-wide automatic anatomy recognition (AAR) methodology was proposed in our previous work based on hierarchical fuzzy models of multitudes of objects which was not tied to any specific organ system, body region, or image modality. That work revealed the challenges encountered in modeling, recognizing, and delineating sparse objects throughout the body (compared to their non-sparse counterparts) if the models are based on the object’s exact geometric representations. The challenges stem mainly from the variation in sparse objects in their shape, topology, geographic layout, and relationship to other objects. That led to the idea of modeling sparse objects not from the precise geometric representations of their samples but by using a properly designed optimal super form. This paper presents the underlying improved methodology which includes 5 steps: (a) Collecting image data from a specific population group G and body region Β and delineating in these images the objects in Β to be modeled; (b) Building a super form, S-form, for each object O in Β; (c) Refining the S-form of O to construct an optimal (minimal) super form, S*-form, which constitutes the (fuzzy) model of O; (d) Recognizing objects in Β using the S*-form; (e) Defining confounding and background objects in each S*-form for each object and performing optimal delineation. Our evaluations based on 50 3D computed tomography (CT) image sets in the thorax on four sparse objects indicate that substantially improved performance (FPVF~2%, FNVF~10%, and success where the previous approach failed) can be achieved using the new approach.
With the rapid growth of positron emission tomography/computed tomography (PET/CT)-based medical applications, body-wide anatomy recognition on whole-body PET/CT images becomes crucial for quantifying body-wide disease burden. This, however, is a challenging problem and seldom studied due to unclear anatomy reference frame and low spatial resolution of PET images as well as low contrast and spatial resolution of the associated low-dose CT images. We previously developed an automatic anatomy recognition (AAR) system  whose applicability was demonstrated on diagnostic computed tomography (CT) and magnetic resonance (MR) images in different body regions on 35 objects. The aim of the present work is to investigate strategies for adapting the previous AAR system to low-dose CT and PET images toward automated body-wide disease quantification. Our adaptation of the previous AAR methodology to PET/CT images in this paper focuses on 16 objects in three body regions – thorax, abdomen, and pelvis – and consists of the following steps: collecting whole-body PET/CT images from existing patient image databases, delineating all objects in these images, modifying the previous hierarchical models built from diagnostic CT images to account for differences in appearance in low-dose CT and PET images, automatically locating objects in these images following object hierarchy, and evaluating performance. Our preliminary evaluations indicate that the performance of the AAR approach on low-dose CT images achieves object localization accuracy within about 2 voxels, which is comparable to the accuracies achieved on diagnostic contrast-enhanced CT images. Object recognition on low-dose CT images from PET/CT examinations without requiring diagnostic contrast-enhanced CT seems feasible.