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Abdominal multi-organ segmentation with organ-attention networks and statistical fusion

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 Added by Seyoun Park
 Publication date 2018
and research's language is English




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Accurate and robust segmentation of abdominal organs on CT is essential for many clinical applications such as computer-aided diagnosis and computer-aided surgery. But this task is challenging due to the weak boundaries of organs, the complexity of the background, and the variable sizes of different organs. To address these challenges, we introduce a novel framework for multi-organ segmentation by using organ-attention networks with reverse connections (OAN-RCs) which are applied to 2D views, of the 3D CT volume, and output estimates which are combined by statistical fusion exploiting structural similarity. OAN is a two-stage deep convolutional network, where deep network features from the first stage are combined with the original image, in a second stage, to reduce the complex background and enhance the discriminative information for the target organs. RCs are added to the first stage to give the lower layers semantic information thereby enabling them to adapt to the sizes of different organs. Our networks are trained on 2D views enabling us to use holistic information and allowing efficient computation. To compensate for the limited cross-sectional information of the original 3D volumetric CT, multi-sectional images are reconstructed from the three different 2D view directions. Then we combine the segmentation results from the different views using statistical fusion, with a novel term relating the structural similarity of the 2D views to the original 3D structure. To train the network and evaluate results, 13 structures were manually annotated by four human raters and confirmed by a senior expert on 236 normal cases. We tested our algorithm and computed Dice-Sorensen similarity coefficients and surface distances for evaluating our estimates of the 13 structures. Our experiments show that the proposed approach outperforms 2D- and 3D-patch based state-of-the-art methods.



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Segmentation of multiple organs-at-risk (OARs) is essential for radiation therapy treatment planning and other clinical applications. We developed an Automated deep Learning-based Abdominal Multi-Organ segmentation (ALAMO) framework based on 2D U-net and a densely connected network structure with tailored design in data augmentation and training procedures such as deep connection, auxiliary supervision, and multi-view. The model takes in multi-slice MR images and generates the output of segmentation results. Three-Tesla T1 VIBE (Volumetric Interpolated Breath-hold Examination) images of 102 subjects were collected and used in our study. Ten OARs were studied, including the liver, spleen, pancreas, left/right kidneys, stomach, duodenum, small intestine, spinal cord, and vertebral bodies. Two radiologists manually labeled and obtained the consensus contours as the ground-truth. In the complete cohort of 102, 20 samples were held out for independent testing, and the rest were used for training and validation. The performance was measured using volume overlapping and surface distance. The ALAMO framework generated segmentation labels in good agreement with the manual results. Specifically, among the 10 OARs, 9 achieved high Dice Similarity Coefficients (DSCs) in the range of 0.87-0.96, except for the duodenum with a DSC of 0.80. The inference completes within one minute for a 3D volume of 320x288x180. Overall, the ALAMO model matches the state-of-the-art performance. The proposed ALAMO framework allows for fully automated abdominal MR segmentation with high accuracy and low memory and computation time demands.
Multi-organ segmentation has extensive applications in many clinical applications. To segment multiple organs of interest, it is generally quite difficult to collect full annotations of all the organs on the same images, as some medical centers might only annotate a portion of the organs due to their own clinical practice. In most scenarios, one might obtain annotations of a single or a few organs from one training set, and obtain annotations of the the other organs from another set of training images. Existing approaches mostly train and deploy a single model for each subset of organs, which are memory intensive and also time inefficient. In this paper, we propose to co-train weight-averaged models for learning a unified multi-organ segmentation network from few-organ datasets. We collaboratively train two networks and let the coupled networks teach each other on un-annotated organs. To alleviate the noisy teaching supervisions between the networks, the weighted-averaged models are adopted to produce more reliable soft labels. In addition, a novel region mask is utilized to selectively apply the consistent constraint on the un-annotated organ regions that require collaborative teaching, which further boosts the performance. Extensive experiments on three public available single-organ datasets LiTS, KiTS, Pancreas and manually-constructed single-organ datasets from MOBA show that our method can better utilize the few-organ datasets and achieves superior performance with less inference computational cost.
We developed a new and computationally simple local block-wise self attention based normal structures segmentation approach applied to head and neck computed tomography (CT) images. Our method uses the insight that normal organs exhibit regularity in their spatial location and inter-relation within images, which can be leveraged to simplify the computations required to aggregate feature information. We accomplish this by using local self attention blocks that pass information between each other to derive the attention map. We show that adding additional attention layers increases the contextual field and captures focused attention from relevant structures. We developed our approach using U-net and compared it against multiple state-of-the-art self attention methods. All models were trained on 48 internal headneck CT scans and tested on 48 CT scans from the external public domain database of computational anatomy dataset. Our method achieved the highest Dice similarity coefficient segmentation accuracy of 0.85$pm$0.04, 0.86$pm$0.04 for left and right parotid glands, 0.79$pm$0.07 and 0.77$pm$0.05 for left and right submandibular glands, 0.93$pm$0.01 for mandible and 0.88$pm$0.02 for the brain stem with the lowest increase of 66.7% computing time per image and 0.15% increase in model parameters compared with standard U-net. The best state-of-the-art method called point-wise spatial attention, achieved textcolor{black}{comparable accuracy but with 516.7% increase in computing time and 8.14% increase in parameters compared with standard U-net.} Finally, we performed ablation tests and studied the impact of attention block size, overlap of the attention blocks, additional attention layers, and attention block placement on segmentation performance.
Most existing approaches to train a unified multi-organ segmentation model from several single-organ datasets require simultaneously access multiple datasets during training. In the real scenarios, due to privacy and ethics concerns, the training data of the organs of interest may not be publicly available. To this end, we investigate a data-free incremental organ segmentation scenario and propose a novel incremental training framework to solve it. We use the pretrained model instead of its own training data for privacy protection. Specifically, given a pretrained $K$ organ segmentation model and a new single-organ dataset, we train a unified $K+1$ organ segmentation model without accessing any data belonging to the previous training stages. Our approach consists of two parts: the background label alignment strategy and the uncertainty-aware guidance strategy. The first part is used for knowledge transfer from the pretained model to the training model. The second part is used to extract the uncertainty information from the pretrained model to guide the whole knowledge transfer process. By combing these two strategies, more reliable information is extracted from the pretrained model without original training data. Experiments on multiple publicly available pretrained models and a multi-organ dataset MOBA have demonstrated the effectiveness of our framework.
Annotating multiple organs in 3D medical images is time-consuming and costly. Meanwhile, there exist many single-organ datasets with one specific organ annotated. This paper investigates how to learn a multi-organ segmentation model leveraging a set of binary-labeled datasets. A novel Multi-teacher Single-student Knowledge Distillation (MS-KD) framework is proposed, where the teacher models are pre-trained single-organ segmentation networks, and the student model is a multi-organ segmentation network. Considering that each teacher focuses on different organs, a region-based supervision method, consisting of logits-wise supervision and feature-wise supervision, is proposed. Each teacher supervises the student in two regions, the organ region where the teacher is considered as an expert and the background region where all teachers agree. Extensive experiments on three public single-organ datasets and a multi-organ dataset have demonstrated the effectiveness of the proposed MS-KD framework.
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