Automatic detection and segmentation of kidneys in 3D CT images using random forests.

Kidney segmentation in 3D CT images allows extracting useful information for nephrologists. For practical use in clinical routine, such an algorithm should be fast, automatic and robust to contrast-agent enhancement and fields of view. By combining and refining state-of-the-art techniques (random forests and template deformation), we demonstrate the possibility of building an algorithm that meets these requirements. Kidneys are localized with random forests following a coarse-to-fine strategy. Their initial positions detected with global contextual information are refined with a cascade of local regression forests. A classification forest is then used to obtain a probabilistic segmentation of both kidneys. The final segmentation is performed with an implicit template deformation algorithm driven by these kidney probability maps. Our method has been validated on a highly heterogeneous database of 233 CT scans from 89 patients. 80% of the kidneys were accurately detected and segmented (Dice coefficient > 0.90) in a few seconds per volume.