Skull Segmentation from CBCT Images via Voxel-Based Rendering.

Skull segmentation from three-dimensional (3D) cone-beam computed tomography (CBCT) images is critical for the diagnosis and treatment planning of the patients with craniomaxillofacial (CMF) deformities. Convolutional neural network (CNN)-based methods are currently dominating volumetric image segmentation, but these methods suffer from the limited GPU memory and the large image size (e.g., 512 \(\times \) 512 \(\times \) 448). Typical ad-hoc strategies, such as down-sampling or patch cropping, will degrade segmentation accuracy due to insufficient capturing of local fine details or global contextual information. Other methods such as Global-Local Networks (GLNet) are focusing on the improvement of neural networks, aiming to combine the local details and the global contextual information in a GPU memory-efficient manner. However, all these methods are operating on regular grids, which are computationally inefficient for volumetric image segmentation. In this work, we propose a novel VoxelRend-based network (VR-U-Net) by combining a memory-efficient variant of 3D U-Net with a voxel-based rendering (VoxelRend) module that refines local details via voxel-based predictions on non-regular grids. Establishing on relatively coarse feature maps, the VoxelRend module achieves significant improvement of segmentation accuracy with a fraction of GPU memory consumption. We evaluate our proposed VR-U-Net in the skull segmentation task on a high-resolution CBCT dataset collected from local hospitals. Experimental results show that the proposed VR-U-Net yields high-quality segmentation results in a memory-efficient manner, highlighting the practical value of our method.