Integration of Swin UNETR and statistical shape modeling for a semi-automated segmentation of the knee and biomechanical modeling of articular cartilage

Abstract: Simulation studies like finite element (FE) modeling provide insight into knee joint mechanics without patient experimentation. Generic FE models represent biomechanical behavior of the tissue by overlooking variations in geometry, loading, and material properties of a population. On the other hand, subject-specific models include these specifics, resulting in enhanced predictive precision. However, creating such models is laborious and time-intensive. The present study aimed to enhance subject-specific knee joint FE modeling by incorporating a semi-automated segmentation algorithm. This segmentation was a 3D Swin UNETR for an initial segmentation of the femur and tibia, followed by a statistical shape model (SSM) adjustment to improve surface roughness and continuity. Five hundred and seven magnetic resonance images (MRIs) from the Osteoarthritis Initiative (OAI) database were used to build and validate the segmentation model. A semi-automated FE model was developed using this semi-automated segmentation. On the other hand, a manual FE model was developed through manual segmentation (i.e., the gold standard approach). Both FE models were subjected to gait loading. The predicted mechanical response of manual and semi-automated FE models were compared. In the result, our semi-automated segmentation achieved Dice similarity coefficient (DSC) over 98% for both femur and tibia. The mechanical results (max principal stress, max principal strain, fluid pressure, fibril strain, and contact area) showed no significant differences between the manual and semi-automated FE models, indicating the effectiveness of the proposed semi-automated segmentation in creating accurate knee joint FE models. ( https://data.mendeley.com/datasets/k5hdc9cz7w/1 ).