Fully automated deep-learning section-based muscle segmentation from CT images for sarcopenia assessment

AIM To develop a fully automated deep-learning-based approach to measure muscle area for assessing sarcopenia on standard-of-care computed tomography (CT) of the abdomen without any case exclusion criteria, for opportunistic screening for frailty. MATERIALS AND METHODS This ethically approved retrospective study used publicly available and institutional unselected abdominal CT images (n=1,070 training, n=31 testing). The method consisted of two sequential steps: section detection from CT volume followed by muscle segmentation on single-section. Both stages used fully convolutional neural networks (FCNN), based on a UNet-like architecture. Input data consisted of CT volumes with a variety of fields of view, section thicknesses, occlusions, artefacts, and anatomical variations. Output consisted of segmented muscle area on a CT section at the L3 vertebral level. The muscle was segmented into …