This work describes an unsupervised method to objectively quantify the abnormality of general anatomical shapes. The severity of an anatomical deformity often serves as a determinant in the clinical management of patients. However, experiential bias and distinctive random residuals among specialist individuals bring variability in diagnosis and patient management decisions, irrespective of the objective deformity degree. Therefore, supervised methods are prone to be misled given insufficient labeling of pathological samples that inevitably preserve human bias and inconsistency. Furthermore, subjects demonstrating a specific pathology are naturally rare relative to the normal population. To avoid relying on sufficient pathological samples by fully utilizing the power of normal samples, we propose the shape normality metric (SNM), which requires learning only from normal samples and zero knowledge about the pathology. We represent shapes by landmarks automatically inferred from the data and model the normal group by a multivariate Gaussian distribution. Extensive experiments on different anatomical datasets, including skulls, femurs, scapulae, and humeri, demonstrate that SNM can provide an effective normality measurement, which can significantly detect and indicate pathology. Therefore, SNM offers promising value in a variety of clinical applications.
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