Automatic Contouring of Spinal Vertebrae on X-Ray using a Novel Sandwich U-Net Architecture

In spinal vertebral mobility disease, accurately extracting and contouring vertebrae is essential for assessing mobility impairments and monitoring variations during flexion-extension movements. Precise vertebral contouring plays a crucial role in surgical planning; however, this process is traditionally performed manually by radiologists or surgeons, making it labour-intensive, time-consuming, and prone to human error. In particular, mobility disease analysis requires the individual contouring of each vertebra, which is both tedious and susceptible to inconsistencies. Automated methods provide a more efficient alternative, enabling vertebra identification, segmentation, and contouring with greater accuracy and reduced time consumption. In this study, we propose a novel U-Net variation designed to accurately segment thoracic vertebrae from anteroposterior view on X-Ray images. Our proposed approach, incorporating a ``sandwich" U-Net structure with dual activation functions, achieves a 4.1\% improvement in Dice score compared to the baseline U-Net model, enhancing segmentation accuracy while ensuring reliable vertebral contour extraction.