InterSliceBoost: Identifying Tissue Layers in Three-dimensional Ultrasound Images for Chronic Lower Back Pain (cLBP) Assessment

Available studies on chronic lower back pain (cLBP) typically focus on one or a few specific tissues rather than conducting a comprehensive layer-by-layer analysis. Since three-dimensional (3-D) images often contain hundreds of slices, manual annotation of these anatomical structures is both time-consuming and error-prone. We aim to develop and validate a novel approach called InterSliceBoost to enable the training of a segmentation model on a partially annotated dataset without compromising segmentation performance. The architecture of InterSliceBoost includes two components: an inter-slice generator and a segmentation model. The generator utilizes residual block-based encoders to extract features from adjacent image-mask pairs (IMPs). Differential features are calculated and input into a decoder to generate inter-slice IMPs. The segmentation model is trained on partially annotated datasets (e.g., skipping 1, 2, 3, or 7 images) and the generated inter-slice IMPs. To validate the performance of InterSliceBoost, we utilized a dataset of 76 B-mode ultrasound scans acquired on 29 subjects enrolled in an ongoing cLBP study. InterSliceBoost, trained on only 33% of the image slices, achieved a mean Dice coefficient of 80.84% across all six layers on the independent test set, with Dice coefficients of 73.48%, 61.11%, 81.87%, 95.74%, 83.52% and 88.74% for segmenting dermis, superficial fat, superficial fascial membrane, deep fat, deep fascial membrane, and muscle. This performance is significantly higher than the conventional model trained on fully annotated images (p<0.05). InterSliceBoost can effectively segment the six tissue layers depicted on 3-D B-model ultrasound images in settings with partial annotations.