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Multi-Slice Dense-Sparse Learning for Efficient Liver and Tumor Segmentation

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 Added by Ziyuan Zhao
 Publication date 2021
and research's language is English




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Accurate automatic liver and tumor segmentation plays a vital role in treatment planning and disease monitoring. Recently, deep convolutional neural network (DCNNs) has obtained tremendous success in 2D and 3D medical image segmentation. However, 2D DCNNs cannot fully leverage the inter-slice information, while 3D DCNNs are computationally expensive and memory intensive. To address these issues, we first propose a novel dense-sparse training flow from a data perspective, in which, densely adjacent slices and sparsely adjacent slices are extracted as inputs for regularizing DCNNs, thereby improving the model performance. Moreover, we design a 2.5D light-weight nnU-Net from a network perspective, in which, depthwise separable convolutions are adopted to improve the efficiency. Extensive experiments on the LiTS dataset have demonstrated the superiority of the proposed method.



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In this work, we report the set-up and results of the Liver Tumor Segmentation Benchmark (LITS) organized in conjunction with the IEEE International Symposium on Biomedical Imaging (ISBI) 2016 and International Conference On Medical Image Computing Computer Assisted Intervention (MICCAI) 2017. Twenty four valid state-of-the-art liver and liver tumor segmentation algorithms were applied to a set of 131 computed tomography (CT) volumes with different types of tumor contrast levels (hyper-/hypo-intense), abnormalities in tissues (metastasectomie) size and varying amount of lesions. The submitted algorithms have been tested on 70 undisclosed volumes. The dataset is created in collaboration with seven hospitals and research institutions and manually reviewed by independent three radiologists. We found that not a single algorithm performed best for liver and tumors. The best liver segmentation algorithm achieved a Dice score of 0.96(MICCAI) whereas for tumor segmentation the best algorithm evaluated at 0.67(ISBI) and 0.70(MICCAI). The LITS image data and manual annotations continue to be publicly available through an online evaluation system as an ongoing benchmarking resource.
Collecting labeled data for the task of semantic segmentation is expensive and time-consuming, as it requires dense pixel-level annotations. While recent Convolutional Neural Network (CNN) based semantic segmentation approaches have achieved impressive results by using large amounts of labeled training data, their performance drops significantly as the amount of labeled data decreases. This happens because deep CNNs trained with the de facto cross-entropy loss can easily overfit to small amounts of labeled data. To address this issue, we propose a simple and effective contrastive learning-based training strategy in which we first pretrain the network using a pixel-wise, label-based contrastive loss, and then fine-tune it using the cross-entropy loss. This approach increases intra-class compactness and inter-class separability, thereby resulting in a better pixel classifier. We demonstrate the effectiveness of the proposed training strategy using the Cityscapes and PASCAL VOC 2012 segmentation datasets. Our results show that pretraining with the proposed contrastive loss results in large performance gains (more than 20% absolute improvement in some settings) when the amount of labeled data is limited. In many settings, the proposed contrastive pretraining strategy, which does not use any additional data, is able to match or outperform the widely-used ImageNet pretraining strategy that uses more than a million additional labeled images.
Automatic segmentation of the liver and hepatic lesions is an important step towards deriving quantitative biomarkers for accurate clinical diagnosis and computer-aided decision support systems. This paper presents a method to automatically segment liver and lesions in CT and MRI abdomen images using cascaded fully convolutional neural networks (CFCNs) enabling the segmentation of a large-scale medical trial or quantitative image analysis. We train and cascade two FCNs for a combined segmentation of the liver and its lesions. In the first step, we train a FCN to segment the liver as ROI input for a second FCN. The second FCN solely segments lesions within the predicted liver ROIs of step 1. CFCN models were trained on an abdominal CT dataset comprising 100 hepatic tumor volumes. Validations on further datasets show that CFCN-based semantic liver and lesion segmentation achieves Dice scores over 94% for liver with computation times below 100s per volume. We further experimentally demonstrate the robustness of the proposed method on an 38 MRI liver tumor volumes and the public 3DIRCAD dataset.
Multi-phase computed tomography (CT) images provide crucial complementary information for accurate liver tumor segmentation (LiTS). State-of-the-art multi-phase LiTS methods usually fused cross-phase features through phase-weighted summation or channel-attention based concatenation. However, these methods ignored the spatial (pixel-wise) relationships between different phases, hence leading to insufficient feature integration. In addition, the performance of existing methods remains subject to the uncertainty in segmentation, which is particularly acute in tumor boundary regions. In this work, we propose a novel LiTS method to adequately aggregate multi-phase information and refine uncertain region segmentation. To this end, we introduce a spatial aggregation module (SAM), which encourages per-pixel interactions between different phases, to make full use of cross-phase information. Moreover, we devise an uncertain region inpainting module (URIM) to refine uncertain pixels using neighboring discriminative features. Experiments on an in-house multi-phase CT dataset of focal liver lesions (MPCT-FLLs) demonstrate that our method achieves promising liver tumor segmentation and outperforms state-of-the-arts.
Using radiological scans to identify liver tumors is crucial for proper patient treatment. This is highly challenging, as top radiologists only achieve F1 scores of roughly 80% (hepatocellular carcinoma (HCC) vs. others) with only moderate inter-rater agreement, even when using multi-phase magnetic resonance (MR) imagery. Thus, there is great impetus for computer-aided diagnosis (CAD) solutions. A critical challenge is to robustly parse a 3D MR volume to localize diagnosable regions of interest (ROI), especially for edge cases. In this paper, we break down this problem using a key-slice parser (KSP), which emulates physician workflows by first identifying key slices and then localizing their corresponding key ROIs. To achieve robustness, the KSP also uses curve-parsing and detection confidence re-weighting. We evaluate our approach on the largest multi-phase MR liver lesion test dataset to date (430 biopsy-confirmed patients). Experiments demonstrate that our KSP can localize diagnosable ROIs with high reliability: 87% patients have an average 3D overlap of >= 40% with the ground truth compared to only 79% using the best tested detector. When coupled with a classifier, we achieve an HCC vs. others F1 score of 0.801, providing a fully-automated CAD performance comparable to top human physicians.

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