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Background: The cost of labeling to collect training data sets using deep learning is especially high in medical applications compared to other fields. Furthermore, due to variances in images depending on the computed tomography (CT) devices, a deep learning based segmentation model trained with a certain device often does not work with images from a different device., Methods: In this study, we propose an efficient learning strategy for deep learning models in medical image segmentation. We aim to overcome the difficulties of segmentation in CT images by training a VNet segmentation model which enables rapid labeling of organs in CT images with the model obtained by transfer learning using a small number of manually labeled images, called SEED images. We established a process for generating SEED images and conducting transfer learning a model. We evaluate the performance of various segmentation models such as vanilla UNet, UNETR, Swin-UNETR and VNet. Furthermore, assuming a scenario that a model is repeatedly trained with CT images collected from multiple devices, in which is catastrophic forgetting often occurs, we examine if the performance of our model degrades., Results: We show that transfer learning can train a model that does a good job of segmenting muscles with a small number of images. In addition, it was confirmed that VNet shows better performance when comparing the performance of existing semi-automated segmentation tools and other deep learning networks to muscle and liver segmentation tasks. Additionally, we confirmed that VNet is the most robust model to deal with catastrophic forgetting problems., Conclusion: In the 2D CT image segmentation task, we confirmed that the CNN-based network shows better performance than the existing semi-automatic segmentation tool or latest transformer-based networks., (© 2024. The Author(s).)

Background: Liver lesions mainly occur inside the liver parenchyma, which are difficult to locate and have complicated relationships with essential vessels. Thus, preoperative planning is crucial for the resection of liver lesions. Accurate segmentation of the hepatic and portal veins (PVs) on computed tomography (CT) images is of great importance for preoperative planning. However, manually labeling the mask of vessels is laborious and time-consuming, and the labeling results of different clinicians are prone to inconsistencies. Hence, developing an automatic segmentation algorithm for hepatic and PVs on CT images has attracted the attention of researchers. Unfortunately, existing deep learning based automatic segmentation methods are prone to misclassifying peripheral vessels into wrong categories., Purpose: This study aims to provide a fully automatic and robust semantic segmentation algorithm for hepatic and PVs, guiding subsequent preoperative planning. In addition, to address the deficiency of the public dataset for hepatic and PV segmentation, we revise the annotations of the Medical Segmentation Decathlon (MSD) hepatic vessel segmentation dataset and add the masks of the hepatic veins (HVs) and PVs., Methods: We proposed a structure with a dual-stream encoder combining convolution and Transformer block, named Dual-stream Hepatic Portal Vein segmentation Network, to extract local features and long-distance spatial information, thereby extracting anatomical information of hepatic and portal vein, avoiding misdivisions of adjacent peripheral vessels. Besides, a multi-scale feature fusion block based on dilated convolution is proposed to extract multi-scale features on expanded perception fields for local features, and a multi-level fusing attention module is introduced for efficient context information extraction. Paired t-test is conducted to evaluate the significant difference in dice between the proposed methods and the comparing methods., Results: Two datasets are constructed from the original MSD dataset. For each dataset, 50 cases are randomly selected for model evaluation in the scheme of 5-fold cross-validation. The results show that our method outperforms the state-of-the-art Convolutional Neural Network-based and transformer-based methods. Specifically, for the first dataset, our model reaches 0.815, 0.830, and 0.807 at overall dice, precision, and sensitivity. The dice of the hepatic and PVs are 0.835 and 0.796, which also exceed the numeric result of the comparing methods. Almost all the p-values of paired t-tests on the proposed approach and comparing approaches are smaller than 0.05. On the second dataset, the proposed algorithm achieves 0.749, 0.762, 0.726, 0.835, and 0.796 for overall dice, precision, sensitivity, dice for HV, and dice for PV, among which the first four numeric results exceed comparing methods., Conclusions: The proposed method is effective in solving the problem of misclassifying interlaced peripheral veins for the HV and PV segmentation task and outperforming the comparing methods on the relabeled dataset., (© 2024 American Association of Physicists in Medicine.)

Accurate segmentation of CT images is crucial for clinical diagnosis and preoperative evaluation of robotic surgery, but challenges arise from fuzzy boundaries and small-sized targets. In response, a novel 2D segmentation network named Context Fusing Attentional Network (CFANet) is proposed. CFANet incorporates three key modules to address these challenges, namely pyramid fusing module (PFM), parallel dilated convolution module (PDCM) and scale attention module (SAM). Integration of these modules into the encoder-decoder structure enables effective utilization of multi-level and multi-scale features. Compared with advanced segmentation method, the Dice score improved by 2.14% on the dataset of liver tumor. This improvement is expected to have a positive impact on the preoperative evaluation of robotic surgery and to support clinical diagnosis, especially in early tumor detection., Competing Interests: Declaration of competing interest None Declared, (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Pulmonary embolism is a kind of cardiovascular disease that threatens human life and health. Since pulmonary embolism exists in the pulmonary artery, improving the segmentation accuracy of pulmonary artery is the key to the diagnosis of pulmonary embolism. Traditional medical image segmentation methods have limited effectiveness in pulmonary artery segmentation. In recent years, deep learning methods have been gradually adopted to solve complex problems in the field of medical image segmentation., Purpose: Due to the irregular shape of the pulmonary artery and the adjacent-complex tissues, the accuracy of the existing pulmonary artery segmentation methods based on deep learning needs to be improved. Therefore, the purpose of this paper is to develop a segmentation network, which can obtain higher segmentation accuracy and further improve the diagnosis effect., Methods: In this study, the pulmonary artery segmentation performance from the network model and loss function is improved, proposing a pulmonary artery segmentation network (PA-Net) to segment the pulmonary artery region from 2D CT images. Reverse Attention and edge attention are used to enhance the expression ability of the boundary. In addition, to better use feature information, the channel attention module is introduced in the decoder to highlight the important channel features and suppress the unimportant channels. Due to blurred boundaries, pixels near the boundaries of the pulmonary artery may be difficult to segment. Therefore, a new contour loss function based on the active contour model is proposed in this study to segment the target region by assigning dynamic weights to false positive and false negative regions and accurately predict the boundary structure., Results: The experimental results show that the segmentation accuracy of this proposed method is significantly improved in comparison with state-of-the-art segmentation methods, and the Dice coefficient is 0.938 ± 0.035, which is also confirmed from the 3D reconstruction results., Conclusions: Our proposed method can accurately segment pulmonary artery structure. This new development will provide the possibility for further rapid diagnosis of pulmonary artery diseases such as pulmonary embolism. Code is available at https://github.com/Yuanyan19/PA-Net., (© 2023 American Association of Physicists in Medicine.)

The lungs of patients with COVID-19 exhibit distinctive lesion features in chest CT images. Fast and accurate segmentation of lesion sites from CT images of patients' lungs is significant for the diagnosis and monitoring of COVID-19 patients. To this end, we propose a progressive dense residual fusion network named PDRF-Net for COVID-19 lung CT segmentation. Dense skip connections are introduced to capture multi-level contextual information and compensate for the feature loss problem in network delivery. The efficient aggregated residual module is designed for the encoding-decoding structure, which combines a visual transformer and the residual block to enable the network to extract richer and minute-detail features from CT images. Furthermore, we introduce a bilateral channel pixel weighted module to progressively fuse the feature maps obtained from multiple branches. The proposed PDRF-Net obtains good segmentation results on two COVID-19 datasets. Its segmentation performance is superior to baseline by 11.6% and 11.1%, and outperforming other comparative mainstream methods. Thus, PDRF-Net serves as an easy-to-train, high-performance deep learning model that can realize effective segmentation of the COVID-19 lung CT images., Competing Interests: Conflict of interestThe authors declare no conflict of interest., (© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

In hip arthroplasty, preoperative planning is fundamental to reaching a successful surgery. Nowadays, several software tools for computed tomography (CT) image processing are available. However, research studies comparing segmentation tools for hip surgery planning for patients affected by osteoarthritic diseases or osteoporotic fractures are still lacking. The present work compares three different software from the geometric, dimensional, and usability perspectives to identify the best three-dimensional (3D) modelling tool for the reconstruction of pathological femoral heads. Syngo.via Frontier (by Siemens Healthcare) is a medical image reading and post-processing software that allows low-skilled operators to produce prototypes. Materialise (by Mimics) is a commercial medical modelling software. 3D Slicer (by slicer.org) is an open-source development platform used in medical and biomedical fields. The 3D models reconstructed starting from the in vivo CT images of the pathological femoral head are compared with the geometries obtained from the laser scan of the in vitro bony specimens. The results show that Mimics and 3D Slicer are better for dimensional and geometric accuracy in the 3D reconstruction, while syngo.via Frontier is the easiest to use in the hospital setting.

Segmentation of the prostate bed, the residual tissue after the removal of the prostate gland, is an essential prerequisite for post-prostatectomy radiotherapy but also a challenging task due to its non-contrast boundaries and highly variable shapes relying on neighboring organs. In this work, we propose a novel deep learning-based method to automatically segment this "invisible target". As the main idea of our design, we expect to get reference from the surrounding normal structures (bladder&rectum) and take advantage of this information to facilitate the prostate bed segmentation. To achieve this goal, we first use a U-Net as the backbone network to perform the bladder&rectum segmentation, which serves as a low-level task that can provide references to the high-level task of the prostate bed segmentation. Based on the backbone network, we build a novel attention network with a series of cascaded attention modules to further extract discriminative features for the high-level prostate bed segmentation task. Since the attention network has one-sided dependency on the backbone network, simulating the clinical workflow to use normal structures to guide the segmentation of radiotherapy target, we name the final composition model asymmetrical multi-task attention U-Net. Extensive experiments on a clinical dataset consisting of 186 CT images demonstrate the effectiveness of this new design and the superior performance of the model in comparison to the conventional atlas-based methods for prostate bed segmentation. The source code is publicly available at https://github.com/superxuang/amta-net.

The article presents a comparative study of influence of the Lanczos resampling filter on improving the accuracy of reconstruction of mandible geometries. The research was performed on eight different patients. Digital Imaging and Communications in Medicine data were obtained on the Siemens Somatom Sensation Open 40 scanner. At the stage of reconstruction, the same parameters were utilized, while only slice thickness was changed. Modeling with voxel dimensions of 0.4 mm × 0.4 mm × 1.5 mm was chosen as the gold standard over the modeling approach comprising voxel dimensions of 0.4 mm × 0.4 mm × 3.0 mm and improved using the Lanczos resampling filter. The influence of the Lanczos resampling filter on the accuracy of reconstruction of mandible geometry is very similar for the eight presented patients. The average results show a distribution with a positive skew and kurtosis. The value of skewness is 0.713 and kurtosis is 4.221 for the model without Lanczos filtering applied. When the Lanczos filtering is applied the value of skewness is 0.542 and kurtosis is 4.313. Based on 95% confidence, changes in layer thickness from 1.5 mm to 3 mm generated errors reconstructing the geometry of the mandible at the value of 0.153 mm ± 1.209 mm. In models improved using the Lanczos resampling filter, the errors generated in reconstructing the geometry of the mandible were minimized at the value of 0.160 mm ± 1.007 mm. The presented research highlights new opportunities to improve the accuracy of reconstruction geometry of the mandible at the stage of data processing.