Medical image segmentation, the task of partitioning an image into meaningful parts, is an important step toward automating medical image analysis and is at the crux of a variety of medical imaging applications, such as computer aided diagnosis, therapy planning and delivery, and computer aided interventions. However, the existence of noise, low contrast and objects' complexity in medical images are critical obstacles that stand in the way of achieving an ideal segmentation system. Incorporating prior knowledge into image segmentation algorithms has proven useful for obtaining more accurate and plausible results. This paper surveys the different types of prior knowledge that have been utilized in different segmentation frameworks. We focus our survey on optimization-based methods that incorporate prior information into their frameworks. We review and compare these methods in terms of the types of prior employed, the domain of formulation (continuous vs. discrete), and the optimization techniques (global vs. local). We also created an interactive online database of existing works and categorized them based on the type of prior knowledge they use. Our website is interactive so that researchers can contribute to keep the database up to date. We conclude the survey by discussing different aspects of designing an energy functional for image segmentation, open problems, and future perspectives.
Recent advances of semantic image segmentation greatly benefit from deeper and larger Convolutional Neural Network (CNN) models. Compared to image segmentation in the wild, properties of both medical images themselves and of existing medical datasets hinder training deeper and larger models because of overfitting. To this end, we propose a novel two-stream UNET architecture for automatic end-to-end medical image segmentation, in which intensity value and gradient vector flow (GVF) are two inputs for each stream, respectively. We demonstrate that two-stream CNNs with more low-level features gre…
In this paper, we propose a novel medical image segmentation using iterative deep learning framework. We have combined an iterative learning approach and an encoder-decoder network to improve segmentation results, which enables to precisely localize the regions of interest (ROIs) including complex shapes or detailed textures of medical images in an iterative manner. The proposed iterative deep convolutional encoder-decoder network consists of two main paths: convolutional encoder path and convolutional decoder path with iterative learning. Experimental results show that the proposed iterative …
Imperial College London（帝国理工学院）；BioMedIA Group, Department of Computing（计算系BioMedIA小组）
Few-shot semantic segmentation (FSS) has great potential for medical imaging applications. Most of the existing FSS techniques require abundant annotated semantic classes for training. However, these methods may not be applicable for medical images due to the lack of annotations. To address this problem we make several contributions: (1) A novel self-supervised FSS framework for medical images in order to eliminate the requirement for annotations during training. Additionally, superpixel-based pseudo-labels are generated to provide supervision; (2) An adaptive local prototype pooling module pl…
We propose an attention mechanism for 3D medical image segmentation. The method, named segmentation-by-detection, is a cascade of a detection module followed by a segmentation module. The detection module enables a region of interest to come to attention and produces a set of object region candidates which are further used as an attention model. Rather than dealing with the entire volume, the segmentation module distills the information from the potential region. This scheme is an efficient solution for volumetric data as it reduces the influence of the surrounding noise which is especially im…
Medical SAM Adapter: Adapting Segment Anything Model for Medical Image Segmentation
University of Oxford（牛津大学）；National University of Singapore（新加坡国立大学）；University of Alberta（阿尔伯塔大学）；A*STAR（新加坡科技研究局）；Carnegie Mellon University（卡内基梅隆大学）；Singapore Eye Research Institute（新加坡眼科研究所）；Mohamed bin Zayed University of Artificial Intelligence（穆罕默德·本·扎耶德人工智能大学）；University of Hongkong（香港大学）
本文提出Medical SAM Adapter（Med-SA），通过轻量适配技术将医学知识融入SAM，利用SD-Trans和HyP-Adpt适配2D模型至3D医学图像，在17个任务上以仅2%参数更新超越SOTA方法。
Université de technologie de Compiègne（贡比涅技术大学）；University of Rouen Normandy（诺曼底鲁昂大学）；Institut universitaire de France（法国大学研究院）
The investigation of uncertainty is of major importance in risk-critical applications, such as medical image segmentation. Belief function theory, a formal framework for uncertainty analysis and multiple evidence fusion, has made significant contributions to medical image segmentation, especially since the development of deep learning. In this paper, we provide an introduction to the topic of medical image segmentation methods using belief function theory. We classify the methods according to the fusion step and explain how information with uncertainty or imprecision is modeled and fused with …
SEG-SAM: Semantic-Guided SAM for Unified Medical Image Segmentation
School of Electronic and Information Engineering, South China University of Technology（华南理工大学电子与信息工程学院）；Pazhou Lab（琶洲实验室）；College of Electronic and Information Engineering, Tongji University（同济大学电子与信息工程学院）
We propose a novel technique to incorporate attention within convolutional neural networks using feature maps generated by a separate convolutional autoencoder. Our attention architecture is well suited for incorporation with deep convolutional networks. We evaluate our model on benchmark segmentation datasets in skin cancer segmentation and lung lesion segmentation. Results show highly competitive performance when compared with U-Net and it's residual variant.
Illinois Institute of Technology（伊利诺伊理工学院）；University of Michigan（密歇根大学）
Recently, due to the increasing requirements of medical imaging applications and the professional requirements of annotating medical images, few-shot learning has gained increasing attention in the medical image semantic segmentation field. To perform segmentation with limited number of labeled medical images, most existing studies use Proto-typical Networks (PN) and have obtained compelling success. However, these approaches overlook the query image features extracted from the proposed representation network, failing to preserving the spatial connection between query and support images. In th…
Northwestern Polytechnical University（西北工业大学）；The University of Adelaide（阿德莱德大学）；Australian Institute for Machine Learning（澳大利亚机器学习研究所）
Manual annotation of medical images is highly subjective, leading to inevitable and huge annotation biases. Deep learning models may surpass human performance on a variety of tasks, but they may also mimic or amplify these biases. Although we can have multiple annotators and fuse their annotations to reduce stochastic errors, we cannot use this strategy to handle the bias caused by annotators' preferences. In this paper, we highlight the issue of annotator-related biases on medical image segmentation tasks, and propose a Preference-involved Annotation Distribution Learning (PADL) framework to …
For medical image analysis, segmentation models trained on one or several domains lack generalization ability to unseen domains due to discrepancies between different data acquisition policies. We argue that the degeneration in segmentation performance is mainly attributed to overfitting to source domains and domain shift. To this end, we present a novel generalizable medical image segmentation method. To be specific, we design our approach as a multi-task paradigm by combining the segmentation model with a self-supervision domain-specific image restoration (DSIR) module for model regularizati…
Deep neural networks have been a prevailing technique in the field of medical image processing. However, the most popular convolutional neural networks (CNNs) based methods for medical image segmentation are imperfect because they model long-range dependencies by stacking layers or enlarging filters. Transformers and the self-attention mechanism are recently proposed to effectively learn long-range dependencies by modeling all pairs of word-to-word attention regardless of their positions. The idea has also been extended to the computer vision field by creating and treating image patches as emb…
Medical Image Segmentation with Belief Function Theory and Deep Learning
University of Technology of Compiègne（贡比涅技术大学）；Heudiasyc Laboratory（欧洲计算机科学与自动化研究院）；University of Paris-Saclay（巴黎萨克雷大学）；University of Artois（阿图瓦大学）；ENSMM School（国立高等机械与微技术学院）；University of Rouen（鲁昂大学）
Segmentation of images is a long-standing challenge in medical AI. This is mainly due to the fact that training a neural network to perform image segmentation requires a significant number of pixel-level annotated data, which is often unavailable. To address this issue, we propose a semi-supervised image segmentation technique based on the concept of multi-view learning. In contrast to the previous art, we introduce an adversarial form of dual-view training and employ a critic to formulate the learning problem in multi-view training as a min-max problem. Thorough quantitative and qualitative e…
Shanghai Jiao Tong University（上海交通大学）；VoxelCloud, Inc.（体素云公司）；University of California, Los Angeles（加利福尼亚大学洛杉矶分校）
Despite the tremendous success of deep neural networks in medical image segmentation, they typically require a large amount of costly, expert-level annotated data. Few-shot segmentation approaches address this issue by learning to transfer knowledge from limited quantities of labeled examples. Incorporating appropriate prior knowledge is critical in designing high-performance few-shot segmentation algorithms. Since strong spatial priors exist in many medical imaging modalities, we propose a prototype-based method -- namely, the location-sensitive local prototype network -- that leverages spati…
Deep learning techniques have successfully been employed in numerous computer vision tasks including image segmentation. The techniques have also been applied to medical image segmentation, one of the most critical tasks in computer-aided diagnosis. Compared with natural images, the medical image is a gray-scale image with low-contrast (even with some invisible parts). Because some organs have similar intensity and texture with neighboring organs, there is usually a need to refine automatic segmentation results. In this paper, we propose an interactive deep refinement framework to improve the …
University of Technology Sydney（悉尼科技大学）；School of Electrical and Data Engineering（电气与数据工程学院）
The Jaccard index, also known as Intersection-over-Union (IoU score), is one of the most critical evaluation metrics in medical image segmentation. However, directly optimizing the mean IoU (mIoU) score over multiple objective classes is an open problem. Although some algorithms have been proposed to optimize its surrogates, there is no guarantee provided for their generalization ability. In this paper, we present a novel data-distribution-aware margin calibration method for a better generalization of the mIoU over the whole data-distribution, underpinned by a rigid lower bound. This scheme en…
University of Augsburg（奥格斯堡大学）；University Hospital Augsburg（奥格斯堡大学医院）
Performance measures are an important tool for assessing and comparing different medical image segmentation algorithms. Unfortunately, the current measures have their weaknesses when it comes to assessing certain edge cases. These limitations arouse when images with a very small region of interest or without a region of interest at all are assessed. As a solution for these limitations, we propose a new medical image segmentation metric: MISm. To evaluate MISm, the popular metrics in the medical image segmentation and MISm were compared using images of magnet resonance tomography from several s…
The University of Sydney（悉尼大学）；Med-X Research Institute, Shanghai Jiao Tong University（上海交通大学Med-X研究院）
The segmentation of medical images is a fundamental step in automated clinical decision support systems. Existing medical image segmentation methods based on supervised deep learning, however, remain problematic because of their reliance on large amounts of labelled training data. Although medical imaging data repositories continue to expand, there has not been a commensurate increase in the amount of annotated data. Hence, we propose a new spatial guided self-supervised clustering network (SGSCN) for medical image segmentation, where we introduce multiple loss functions designed to aid in gro…
Nagoya University（名古屋大学）；Aichi Cancer Center Hospital（爱知县癌症中心医院）
One of the most common tasks in medical imaging is semantic segmentation. Achieving this segmentation automatically has been an active area of research, but the task has been proven very challenging due to the large variation of anatomy across different patients. However, recent advances in deep learning have made it possible to significantly improve the performance of image recognition and semantic segmentation methods in the field of computer vision. Due to the data driven approaches of hierarchical feature learning in deep learning frameworks, these advances can be translated to medical ima…
MedVeriSeg: Teaching LISA-Like Medical Segmentation Models to Verify Query Validity Without Extra Training
School of Aeronautics and Astronautics, Zhejiang University（浙江大学航空宇航学院）；Southern Medical University（南方医科大学）；School of Computer Science and Technology (School of Artificial Intelligence), Zhejiang Sci-Tech University（浙江科技学院计算机科学与技术学院（人工智能学院））；College of Information Science and Electronic Engineering, Zhejiang University（浙江大学信息科学与电子工程学院）
Accurate and fast segmentation of medical images is clinically essential, yet current research methods include convolutional neural networks with fast inference speed but difficulty in learning image contextual features, and transformer with good performance but high hardware requirements. In this paper, we present a Patch Network (PNet) that incorporates the Swin Transformer notion into a convolutional neural network, allowing it to gather richer contextual information while achieving the balance of speed and accuracy. We test our PNet on Polyp(CVC-ClinicDB and ETIS- LaribPolypDB), Skin(ISIC-…
Hebei University of Technology（河北工业大学）；University of Macau（澳门大学）；University of Oxford（牛津大学）；Hospital of Joint Logistics Support Force（联勤保障部队第九八三医院）
Deep learning-based medical image segmentation technology aims at automatic recognizing and annotating objects on the medical image. Non-local attention and feature learning by multi-scale methods are widely used to model network, which drives progress in medical image segmentation. However, those attention mechanism methods have weakly non-local receptive fields' strengthened connection for small objects in medical images. Then, the features of important small objects in abstract or coarse feature maps may be deserted, which leads to unsatisfactory performance. Moreover, the existing multi-sc…
Johns Hopkins University（约翰斯·霍普金斯大学）；Rutgers, The State University of New Jersey（罗格斯新泽西州立大学）
Over the past decade, Deep Convolutional Neural Networks have been widely adopted for medical image segmentation and shown to achieve adequate performance. However, due to the inherent inductive biases present in the convolutional architectures, they lack understanding of long-range dependencies in the image. Recently proposed Transformer-based architectures that leverage self-attention mechanism encode long-range dependencies and learn representations that are highly expressive. This motivates us to explore Transformer-based solutions and study the feasibility of using Transformer-based netwo…
Transformers have shown great success in medical image segmentation. However, transformers may exhibit a limited generalization ability due to the underlying single-scale self-attention (SA) mechanism. In this paper, we address this issue by introducing a Multi-scale hiERarchical vIsion Transformer (MERIT) backbone network, which improves the generalizability of the model by computing SA at multiple scales. We also incorporate an attention-based decoder, namely Cascaded Attention Decoding (CASCADE), for further refinement of multi-stage features generated by MERIT. Finally, we introduce an eff…
Medical image segmentation is a relevant task as it serves as the first step for several diagnosis processes, thus it is indispensable in clinical usage. Whilst major success has been reported using supervised techniques, they assume a large and well-representative labelled set. This is a strong assumption in the medical domain where annotations are expensive, time-consuming, and inherent to human bias. To address this problem, unsupervised techniques have been proposed in the literature yet it is still an open problem due to the difficulty of learning any transformation pattern. In this work,…
King Abdullah University of Science and Technology (KAUST)（阿卜杜拉国王科技大学）；Universidad de los Andes（洛斯安第斯大学）
The reliability of Deep Learning systems depends on their accuracy but also on their robustness against adversarial perturbations to the input data. Several attacks and defenses have been proposed to improve the performance of Deep Neural Networks under the presence of adversarial noise in the natural image domain. However, robustness in computer-aided diagnosis for volumetric data has only been explored for specific tasks and with limited attacks. We propose a new framework to assess the robustness of general medical image segmentation systems. Our contributions are two-fold: (i) we propose a…
Model Agnostic Preference Optimization for Medical Image Segmentation
DGIST, School of Undergrad Studies（DGIST研究生院）；DGIST, Department of Robotics and Mechatronics Engineering（DGIST机器人与机电工程系）；DGIST, Division of Intelligent Robot（DGIST智能机器人系）
Coarse-to-fine models and cascade segmentation architectures are widely adopted to solve the problem of large scale variations in medical image segmentation. However, those methods have two primary limitations: the first-stage segmentation becomes a performance bottleneck; the lack of overall differentiability makes the training process of two stages asynchronous and inconsistent. In this paper, we propose a differentiable two-stage network architecture to tackle these problems. In the first stage, a localization network (L-Net) locates Regions of Interest (RoIs) in a detection fashion; in the…
Deep neural network (DNN) based approaches have been widely investigated and deployed in medical image analysis. For example, fully convolutional neural networks (FCN) achieve the state-of-the-art performance in several applications of 2D/3D medical image segmentation. Even the baseline neural network models (U-Net, V-Net, etc.) have been proven to be very effective and efficient when the training process is set up properly. Nevertheless, to fully exploit the potentials of neural networks, we propose an automated searching approach for the optimal training strategy with reinforcement learning.…
Medical image annotation is a major hurdle for developing precise and robust machine learning models. Annotation is expensive, time-consuming, and often requires expert knowledge, particularly in the medical field. Here, we suggest using minimal user interaction in the form of extreme point clicks to train a segmentation model which, in effect, can be used to speed up medical image annotation. An initial segmentation is generated based on the extreme points utilizing the random walker algorithm. This initial segmentation is then used as a noisy supervision signal to train a fully convolutional…
I-MedSAM: Implicit Medical Image Segmentation with Segment Anything
Peking University（北京大学）；University of Chinese Academy of Sciences（中国科学院大学）；Institute of Software, Chinese Academy of Sciences（中国科学院软件研究所）；Beihang University（北京航空航天大学）；Beijing University of Posts and Telecommunications（北京邮电大学）
Multi-dimension Transformer with Attention-based Filtering for Medical Image Segmentation
University of Alabama at Birmingham（阿拉巴马大学伯明翰分校）；Chongqing University of Posts and Telecommunications（重庆邮电大学）；Alipurduar Government Engineering and Management College（阿里布尔杜阿尔政府工程与管理学院）
Interactive 3D Medical Image Segmentation with SAM 2
East China Normal University（华东师范大学）；Tongji University（同济大学）；Shanghai United Imaging Healthcare Advanced Technology Research Institute Co., Ltd.（上海联影医疗科技先进技术研究院有限公司）
本文提出将 3D 医学切片视为视频帧、利用 SAM 2 零样本传播单帧标注的交互式分割流程，实验表明其可在特定场景缩小与监督方法差距并降低标注成本。
FlowSDF: Flow Matching for Medical Image Segmentation Using Distance Transforms
Institute of Computer Graphics and Vision（计算机图形与视觉研究所）；Graz University of Technology（格拉茨工业大学）；Photogrammetry and Remote Sensing（摄影测量与遥感研究所）；ETH Zurich（苏黎世联邦理工学院）
Enhancing the Reliability of Segment Anything Model for Auto-Prompting Medical Image Segmentation with Uncertainty Rectification
Artificial Intelligence Innovation and Incubation Institute, Fudan University（复旦大学人工智能创新与孵化研究院）；Shanghai Academy of Artificial Intelligence for Science（上海科学人工智能研究院）
In recent years, deep learning has rapidly become a method of choice for the segmentation of medical images. Deep Neural Network (DNN) architectures such as UNet have achieved state-of-the-art results on many medical datasets. To further improve the performance in the segmentation task, we develop an ensemble system which combines various deep learning architectures. We propose a two-layer ensemble of deep learning models for the segmentation of medical images. The prediction for each training image pixel made by each model in the first layer is used as the augmented data of the training image…
Johns Hopkins University（约翰斯·霍普金斯大学）；University of Electronic Science and Technology of China（电子科技大学）；Stanford University（斯坦福大学）；East China Normal University（华东师范大学）；PAII Inc.（PAII公司）
Medical image segmentation is an essential prerequisite for developing healthcare systems, especially for disease diagnosis and treatment planning. On various medical image segmentation tasks, the u-shaped architecture, also known as U-Net, has become the de-facto standard and achieved tremendous success. However, due to the intrinsic locality of convolution operations, U-Net generally demonstrates limitations in explicitly modeling long-range dependency. Transformers, designed for sequence-to-sequence prediction, have emerged as alternative architectures with innate global self-attention mech…
Lister Hill National Center for Biomedical Communications（李斯特·希尔国家生物医学交流中心）；National Heart, Lung, and Blood Institute（国家心肺血液研究所）
Accurate segmentation of medical images into anatomically meaningful regions is critical for the extraction of quantitative indices or biomarkers. The common pipeline for segmentation comprises regions of interest detection stage and segmentation stage, which are independent of each other and typically performed using separate deep learning networks. The performance of the segmentation stage highly relies on the extracted set of spatial features and the receptive fields. In this work, we propose an end-to-end network, called Trilateral Attention Network (TaNet), for real-time detection and seg…
Due to the limitation of available labeled data, medical image segmentation is a challenging task for deep learning. Traditional data augmentation techniques have been shown to improve segmentation network performances by optimizing the usage of few training examples. However, current augmentation approaches for segmentation do not tackle the strong texture bias of convolutional neural networks, observed in several studies. This work shows on the MoNuSeg dataset that style augmentation, which is already used in classification tasks, helps reducing texture over-fitting and improves segmentation…
Nanjing University of Science and Technology（南京理工大学）
Segmentation is one of the most important and popular tasks in medical image analysis, which plays a critical role in disease diagnosis, surgical planning, and prognosis evaluation. During the past five years, on the one hand, thousands of medical image segmentation methods have been proposed for various organs and lesions in different medical images, which become more and more challenging to fairly compare different methods. On the other hand, international segmentation challenges can provide a transparent platform to fairly evaluate and compare different methods. In this paper, we present a …
Generalizability is seen as one of the major challenges in deep learning, in particular in the domain of medical imaging, where a change of hospital or in imaging routines can lead to a complete failure of a model. To tackle this, we introduce Consistency Training, a training procedure and alternative to data augmentation based on maximizing models' prediction consistency across augmented and unaugmented data in order to facilitate better out-of-distribution generalization. To this end, we develop a novel region-based segmentation loss function called Segmentation Inconsistency Loss (SIL), whi…
Image segmentation is often performed on medical images for identifying diseases in clinical evaluation. Hence it has become one of the major research areas. Conventional image segmentation techniques are unable to provide satisfactory segmentation results for medical images as they contain irregularities. They need to be pre-processed before segmentation. In order to obtain the most suitable method for medical image segmentation, we propose a two stage algorithm. The first stage automatically generates a binary marker image of the region of interest using mathematical morphology. This marker …
South China University of Technology（华南理工大学）；University of Utah（犹他大学）
We introduce the idea of inter-slice image augmentation whereby the numbers of the medical images and the corresponding segmentation labels are increased between two consecutive images in order to boost medical image segmentation accuracy. Unlike conventional data augmentation methods in medical imaging, which only increase the number of training samples directly by adding new virtual samples using simple parameterized transformations such as rotation, flipping, scaling, etc., we aim to augment data based on the relationship between two consecutive images, which increases not only the number b…
