# White Matter and Gray Matter Segmentation in 4D Computed Tomography

R. Manniesing, M. Oei, L. Oostveen, J. Melendez, E. Smit, B. Platel, C. Sánchez, F. Meijer, M. Prokop and B. van Ginneken

Nature Scientific Reports 2017;7(119).

Modern Computed Tomography (CT) scanners are capable of acquiring contrast dynamics of the whole brain, adding functional to anatomical information. Soft tissue segmentation is important for subsequent applications such as tissue dependent perfusion analysis and automated detection and quantification of cerebral pathology. In this work a method is presented to automatically segment white matter (WM) and gray matter (GM) in contrast- enhanced 4D CT images of the brain. The method starts with intracranial segmentation via atlas registration, followed by a refinement using a geodesic active contour with dominating advection term steered by image gradient information, from a 3D temporal average image optimally weighted according to the exposures of the individual time points of the 4D CT acquisition. Next, three groups of voxel features are extracted: intensity, contextual, and temporal. These are used to segment WM and GM with a support vector machine. Performance was assessed using cross validation in a leave-one-patient-out manner on 22 patients. Dice coefficients were 0.81$\pm$0.04 and 0.79$\pm$0.05, 95% Hausdorff distances were 3.86$\pm$1.43 and 3.07$\pm$1.72 mm, for WM and GM, respectively. Thus, WM and GM segmentation is feasible in 4D CT with good accuracy.