Deep learning in magnetic resonance prostate segmentation: A review and a new perspective
Manchester Metropolitan University（曼彻斯特城市大学）；NHS（英国国民保健署）；The Leeds Teaching Hospital（利兹教学医院）；The Clatterbridge Cancer Center（克莱特布里奇癌症中心）；Leicester University（莱斯特大学）
David Gillespie, Connah Kendrick, Ian Boon, Cheng Boon, Tim Rattay, Moi Hoon Yap
Prostate radiotherapy is a well established curative oncology modality, which in future will use Magnetic Resonance Imaging (MRI)-based radiotherapy for daily adaptive radiotherapy target definition. However the time needed to delineate the prostate from MRI data accurately is a time consuming process. Deep learning has been identified as a potential new technology for the delivery of precision radiotherapy in prostate cancer, where accurate prostate segmentation helps in cancer detection and therapy. However, the trained models can be limited in their application to clinical setting due to different acquisition protocols, limited publicly available datasets, where the size of the datasets are relatively small. Therefore, to explore the field of prostate segmentation and to discover a generalisable solution, we review the state-of-the-art deep learning algorithms in MR prostate segmentation; provide insights to the field by discussing their limitations and strengths; and propose an optimised 2D U-Net for MR prostate segmentation. We evaluate the performance on four publicly available datasets using Dice Similarity Coefficient (DSC) as performance metric. Our experiments include within dataset evaluation and cross-dataset evaluation. The best result is achieved by composite evaluation (DSC of 0.9427 on Decathlon test set) and the poorest result is achieved by cross-dataset evaluation (DSC of 0.5892, Prostate X training set, Promise 12 testing set). We outline the challenges and provide recommendations for future work. Our research provides a new perspective to MR prostate segmentation and more importantly, we provide standardised experiment settings for researchers to evaluate their algorithms. Our code is available at https://github.com/AIEMMU/MRI\_Prostate.
East China University of Science and Technology（华东理工大学）
Prostate cancer is one of the common diseases in men, and it is the most common malignant tumor in developed countries. Studies have shown that the male prostate incidence rate is as high as 2.5% to 16%, Currently, the inci-dence of prostate cancer in Asia is lower than that in the West, but it is increas-ing rapidly. If prostate cancer can be found as early as possible and treated in time, it will have a high survival rate. Therefore, it is of great significance for the diagnosis and treatment of prostate cancer. In this paper, we propose a trans-fer learning method based on deep neural netwo…
University of California, Los Angeles (UCLA)（加利福尼亚大学洛杉矶分校）；The First Affiliated Hospital of China Medical University（中国医科大学附属第一医院）；VoxelCloud, Inc.（体素云公司）
Prostate cancer is the second leading cause of cancer death among men in the United States. The diagnosis of prostate MRI often relies on the accurate prostate zonal segmentation. However, state-of-the-art automatic segmentation methods often fail to produce well-contained volumetric segmentation of the prostate zones since certain slices of prostate MRI, such as base and apex slices, are harder to segment than other slices. This difficulty can be overcome by accounting for the cross-slice relationship of adjacent slices, but current methods do not fully learn and exploit such relationships. I…
3D EAGAN: 3D edge-aware attention generative adversarial network for prostate segmentation in transrectal ultrasound images
Nanchang Hangkong University（南昌航空大学）；Nanjing University of Information Science and Technology（南京信息工程大学）；The First Affiliated Hospital of Nanchang University（南昌大学第一附属医院）
Precise determination of target is an essential procedure in prostate interventions, such as the prostate biopsy, lesion detection and targeted therapy. However, the prostate delineation may be tough in some cases due to tissue ambiguity or lack of partial anatomical boundary. To address this problem, we proposed a weakly supervised registration-based framework for the precise prostate segmentation, by combining convolutional neural network (CNN) with statistical shape model (SSM). To obtain the prostate region, an inception-based neural network (SSM-Net) was firstly exploited to predict the m…
In this work we propose to segment the prostate on a challenging dataset of trans-rectal ultrasound (TRUS) images using convolutional neural networks (CNNs) and statistical shape models (SSMs). TRUS is commonly used for a number of image-guided interventions on the prostate. Fast and accurate segmentation on the organ in these images is crucial to planning and fusion with other modalities such as magnetic resonance images (MRIs) . However, TRUS has limited soft tissue contrast and signal to noise ratio which makes the task of segmenting the prostate challenging and subject to inter-observer an…
Prostate cancer is one of the most prevalent cancers worldwide. One of the key factors in reducing its mortality is based on early detection. The computer-aided diagnosis systems for this task are based on the glandular structural analysis in histology images. Hence, accurate gland detection and segmentation is crucial for a successful prediction. The methodological basis of this work is a prostate gland segmentation based on U-Net convolutional neural network architectures modified with residual and multi-resolution blocks, trained using data augmentation techniques. The residual configuratio…
Worldwide, prostate cancer is one of the main cancers affecting men. The final diagnosis of prostate cancer is based on the visual detection of Gleason patterns in prostate biopsy by pathologists. Computer-aided-diagnosis systems allow to delineate and classify the cancerous patterns in the tissue via computer-vision algorithms in order to support the physicians' task. The methodological core of this work is a U-Net convolutional neural network for image segmentation modified with residual blocks able to segment cancerous tissue according to the full Gleason system. This model outperforms othe…
We hypothesize that probabilistic voxel-level classification of anatomy and malignancy in prostate MRI, although typically posed as near-identical segmentation tasks via U-Nets, require different loss functions for optimal performance due to inherent differences in their clinical objectives. We investigate distribution, region and boundary-based loss functions for both tasks across 200 patient exams from the publicly-available ProstateX dataset. For evaluation, we conduct a thorough comparative analysis of model predictions and calibration, measured with respect to multi-class volume segmentat…
Université de Bourgogne Franche-Comté（勃艮第-弗朗什孔泰大学）；CGFL（CGFL（第戎乔治·弗朗索瓦·勒克莱尔中心））；University Hospital of Dijon（第戎大学医院）
Deep learning has shown unprecedented success in a variety of applications, such as computer vision and medical image analysis. However, there is still potential to improve segmentation in multimodal images by embedding prior knowledge via learning-based shape modeling and registration to learn the modality invariant anatomical structure of organs. For example, in radiotherapy automatic prostate segmentation is essential in prostate cancer diagnosis, therapy, and post-therapy assessment from T2-weighted MR or CT images. In this paper, we present a fully automatic deep generative model-driven m…
Institute of Computer Science, FORTH（福拉什计算机科学研究所）；Hellenic Mediterranean University（希腊地中海大学）；University of Ioannina（约阿尼纳大学）
Prostate segmentation from magnetic resonance imaging (MRI) is a challenging task. In recent years, several network architectures have been proposed to automate this process and alleviate the burden of manual annotation. Although the performance of these models has achieved promising results, there is still room for improvement before these models can be used safely and effectively in clinical practice. One of the major challenges in prostate MR image segmentation is the presence of class imbalance in the image labels where the background pixels dominate over the prostate. In the present work …
Multi-parametric MR images have been shown to be effective in the non-invasive diagnosis of prostate cancer. Automated segmentation of the prostate eliminates the need for manual annotation by a radiologist which is time consuming. This improves efficiency in the extraction of imaging features for the characterization of prostate tissues. In this work, we propose a fully automated cascaded deep learning architecture with residual blocks, Cascaded MRes-UNET, for segmentation of the prostate gland and the peripheral zone in one pass through the network. The network yields high Dice scores ($0.91…
University of Magdeburg（马格德堡大学）；Fraunhofer Institute for Digital Medicine MEVIS（弗劳恩霍夫数字医学研究所 MEVIS）；Radboud University Medical Center（拉德堡德大学医学中心）；University Hospital Magdeburg（马格德堡大学医院）；University of Bremen（不来梅大学）
Background and Objective: Accurate and reliable segmentation of the prostate gland in MR images can support the clinical assessment of prostate cancer, as well as the planning and monitoring of focal and loco-regional therapeutic interventions. Despite the availability of multi-planar MR scans due to standardized protocols, the majority of segmentation approaches presented in the literature consider the axial scans only. Methods: We propose an anisotropic 3D multi-stream CNN architecture, which processes additional scan directions to produce a higher-resolution isotropic prostate segmentation.…
University of California, Los Angeles（加利福尼亚大学洛杉矶分校）；Imperial College London（伦敦帝国学院）
Our main objective is to develop a novel deep learning-based algorithm for automatic segmentation of prostate zone and to evaluate the proposed algorithm on an additional independent testing data in comparison with inter-reader consistency between two experts. With IRB approval and HIPAA compliance, we designed a novel convolutional neural network (CNN) for automatic segmentation of the prostatic transition zone (TZ) and peripheral zone (PZ) on T2-weighted (T2w) MRI. The total study cohort included 359 patients from two sources; 313 from a deidentified publicly available dataset (SPIE-AAPM-NCI…
Prostate cancer was the third most common cancer in 2020 internationally, coming after breast cancer and lung cancer. Furthermore, in recent years prostate cancer has shown an increasing trend. According to clinical experience, if this problem is detected and treated early, there can be a high chance of survival for the patient. One task that helps diagnose prostate cancer is prostate segmentation from magnetic resonance imaging. Manual segmentation performed by clinical experts has its drawbacks such as: the high time and concentration required from observers; and inter- and intra-observer va…
The Chinese University of Hong Kong（香港中文大学）；Stanford University（斯坦福大学）；Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences（中国科学院深圳先进技术研究院）
Automated prostate segmentation in MRI is highly demanded for computer-assisted diagnosis. Recently, a variety of deep learning methods have achieved remarkable progress in this task, usually relying on large amounts of training data. Due to the nature of scarcity for medical images, it is important to effectively aggregate data from multiple sites for robust model training, to alleviate the insufficiency of single-site samples. However, the prostate MRIs from different sites present heterogeneity due to the differences in scanners and imaging protocols, raising challenges for effective ways o…
Leiden University Medical Center（莱顿大学医学中心）；University Medical Center Utrecht（乌得勒支大学医学中心）
Joint image registration and segmentation has long been an active area of research in medical imaging. Here, we reformulate this problem in a deep learning setting using adversarial learning. We consider the case in which fixed and moving images as well as their segmentations are available for training, while segmentations are not available during testing; a common scenario in radiotherapy. The proposed framework consists of a 3D end-to-end generator network that estimates the deformation vector field (DVF) between fixed and moving images in an unsupervised fashion and applies this DVF to the …
Tecnologico de Monterrey（蒙特雷科技大学）；CIATEQ A.C.（CIATEQ先进技术中心）；Universitat Politècnica de Catalunya（加泰罗尼亚理工大学）；Hospital Sant Joan de Déu（圣胡安德迪奥斯医院）
Prostate cancer is the second-most frequently diagnosed cancer and the sixth leading cause of cancer death in males worldwide. The main problem that specialists face during the diagnosis of prostate cancer is the localization of Regions of Interest (ROI) containing a tumor tissue. Currently, the segmentation of this ROI in most cases is carried out manually by expert doctors, but the procedure is plagued with low detection rates (of about 27-44%) or overdiagnosis in some patients. Therefore, several research works have tackled the challenge of automatically segmenting and extracting features o…
Organ image segmentation can be improved by implementing prior knowledge about the anatomy. One way of doing this is by training an autoencoder to learn a lowdimensional representation of the segmentation. In this paper, this is applied in multi-label prostate MR segmentation, with some positive results.
Stanford University（斯坦福大学）；University College London（伦敦大学学院）；University of California Los Angeles（加利福尼亚大学洛杉矶分校）
Prostate biopsy and image-guided treatment procedures are often performed under the guidance of ultrasound fused with magnetic resonance images (MRI). Accurate image fusion relies on accurate segmentation of the prostate on ultrasound images. Yet, the reduced signal-to-noise ratio and artifacts (e.g., speckle and shadowing) in ultrasound images limit the performance of automated prostate segmentation techniques and generalizing these methods to new image domains is inherently difficult. In this study, we address these challenges by introducing a novel 2.5D deep neural network for prostate segm…
MCICSAM: Monte Carlo-guided Interpolation Consistency Segment Anything Model for Semi-Supervised Prostate Zone Segmentation
College of Medicine and Biological Information Engineering, Northeastern University（东北大学医学与生物信息工程学院）；Shengjing Hospital of China Medical University（中国医科大学附属盛京医院）；University of Chicago（芝加哥大学）；University of Dundee（邓迪大学）；School of Health Management, China Medical University（中国医科大学健康管理学院）
AI-based Automatic Segmentation of Prostate on Multi-modality Images: A Review
Soochow University（苏州大学）；Peking University First Hospital（北京大学第一医院）；Duke Kunshan University（昆山杜克大学）；Swinburne University of Technology（斯威本科技大学）；The Hong Kong Polytechnic University（香港理工大学）；UT Southwestern Medical Center（德克萨斯大学西南医学中心）
Prostate cancer is one of the main diseases affecting men worldwide. The Gleason scoring system is the primary diagnostic tool for prostate cancer. This is obtained via the visual analysis of cancerous patterns in prostate biopsies performed by expert pathologists, and the aggregation of the main Gleason grades in a combined score. Computer-aided diagnosis systems allow to reduce the workload of pathologists and increase the objectivity. Recently, efforts have been made in the literature to develop algorithms aiming the direct estimation of the global Gleason score at biopsy/core level with gl…
The diagnosis of prostate cancer faces a problem with overdiagnosis that leads to damaging side effects due to unnecessary treatment. Research has shown that the use of multi-parametric magnetic resonance images to conduct biopsies can drastically help to mitigate the overdiagnosis, thus reducing the side effects on healthy patients. This study aims to investigate the use of deep learning techniques to explore computer-aid diagnosis based on MRI as input. Several diagnosis problems ranging from classification of lesions as being clinically significant or not to the detection and segmentation o…
Whole gland (WG) segmentation of the prostate plays a crucial role in detection, staging and treatment planning of prostate cancer (PCa). Despite promise shown by deep learning (DL) methods, they rely on the availability of a considerable amount of annotated data. Augmentation techniques such as translation and rotation of images present an alternative to increase data availability. Nevertheless, the amount of information provided by the transformed data is limited due to the correlation between the generated data and the original. Based on the recent success of generative adversarial networks…
The interpretation of prostate MRI suffers from low agreement across radiologists due to the subtle differences between cancer and normal tissue. Image registration addresses this issue by accurately mapping the ground-truth cancer labels from surgical histopathology images onto MRI. Cancer labels achieved by image registration can be used to improve radiologists' interpretation of MRI by training deep learning models for early detection of prostate cancer. A major limitation of current automated registration approaches is that they require manual prostate segmentations, which is a time-consum…
Nanjing University（南京大学）；National Institute of Healthcare Data Science at Nanjing University（南京大学医疗健康数据科学国家研究院）；Nanjing Drum Tower Hospital, Nanjing University Medical School（南京大学医学院附属鼓楼医院）；Shanghai United Imaging Intelligence Co., Ltd.（上海联影智能科技有限公司）；Korea University（高丽大学）
Accurate segmentation of the prostate is a key step in external beam radiation therapy treatments. In this paper, we tackle the challenging task of prostate segmentation in CT images by a two-stage network with 1) the first stage to fast localize, and 2) the second stage to accurately segment the prostate. To precisely segment the prostate in the second stage, we formulate prostate segmentation into a multi-task learning framework, which includes a main task to segment the prostate, and an auxiliary task to delineate the prostate boundary. Here, the second task is applied to provide additional…
Khalifa University（哈利法大学）；Beihang University（北京航空航天大学）；University of Louisville（路易斯维尔大学）
Prostate cancer (PCa) is the second deadliest form of cancer in males, and it can be clinically graded by examining the structural representations of Gleason tissues. This paper proposes \RV{a new method} for segmenting the Gleason tissues \RV{(patch-wise) in order to grade PCa from the whole slide images (WSI).} Also, the proposed approach encompasses two main contributions: 1) A synergy of hybrid dilation factors and hierarchical decomposition of latent space representation for effective Gleason tissues extraction, and 2) A three-tiered loss function which can penalize different semantic seg…
Deep Attentive Features for Prostate Segmentation in 3D Transrectal Ultrasound
Shenzhen University（深圳大学）；The Chinese University of Hong Kong（香港中文大学）；The Hong Kong Polytechnic University（香港理工大学）；Sun Yat-Sen University（中山大学）；the First Affiliated Hospital（第一附属医院）
IBM Research Europe（IBM欧洲研究院）；Harvard Medical School（哈佛医学院）；Massachusetts General Hospital（麻省总医院）；Broad Institute of Harvard and MIT（哈佛-麻省理工博德研究所）；Dana-Farber/Harvard Cancer Center（丹娜-法伯/哈佛癌症中心）；ETH Zurich（苏黎世联邦理工学院）；EPFL（洛桑联邦理工学院）；Uppsala University（乌普萨拉大学）
The segmentation and automatic identification of histological regions of diagnostic interest offer a valuable aid to pathologists. However, segmentation methods are hampered by the difficulty of obtaining pixel-level annotations, which are tedious and expensive to obtain for Whole-Slide images (WSI). To remedy this, weakly supervised methods have been developed to exploit the annotations directly available at the image level. However, to our knowledge, none of these techniques is adapted to deal with WSIs. In this paper, we propose WholeSIGHT, a weakly-supervised method, to simultaneously segm…
Promptable segmentation with region exploration enables minimal-effort expert-level prostate cancer delineation
UCL Hawkes Institute（UCL Hawkes Institute；医学物理与生物医学工程系）；Department of Medical Physics and Biomedical Engineering（大学学院伦敦）；University College London（医学成像中心）；Centre of Medical Imaging（肿瘤学系）；Department of Oncology（阿迦·柯尔大学医院）；Aga Khan University Hospital（生物工程中心；工程与材料科学学院）；Centre for Bioengineering；School of Engineering and Materials Science
University of Magdeburg（马格德堡大学）；University Hospital Magdeburg（马格德堡大学医院）
Various convolutional neural network (CNN) based concepts have been introduced for the prostate's automatic segmentation and its coarse subdivision into transition zone (TZ) and peripheral zone (PZ). However, when targeting a fine-grained segmentation of TZ, PZ, distal prostatic urethra (DPU) and the anterior fibromuscular stroma (AFS), the task becomes more challenging and has not yet been solved at the level of human performance. One reason might be the insufficient amount of labeled data for supervised training. Therefore, we propose to apply a semi-supervised learning (SSL) technique named…
With numerous medical tasks, the performance of deep models has recently experienced considerable improvements. These models are often adept learners. Yet, their intricate architectural design and high computational complexity make deploying them in clinical settings challenging, particularly with devices with limited resources. To deal with this issue, Knowledge Distillation (KD) has been proposed as a compression method and an acceleration technology. KD is an efficient learning strategy that can transfer knowledge from a burdensome model (i.e., teacher model) to a lightweight model (i.e., s…
Despite the great success of convolutional neural networks (CNN) in 3D medical image segmentation tasks, the methods currently in use are still not robust enough to the different protocols utilized by different scanners, and to the variety of image properties or artefacts they produce. To this end, we introduce OOCS-enhanced networks, a novel architecture inspired by the innate nature of visual processing in the vertebrates. With different 3D U-Net variants as the base, we add two 3D residual components to the second encoder blocks: on and off center-surround (OOCS). They generalise the gangli…
Purpose: We aimed to develop deep machine learning (DL) models to improve the detection and segmentation of intraprostatic lesions (IL) on bp-MRI by using whole amount prostatectomy specimen-based delineations. We also aimed to investigate whether transfer learning and self-training would improve results with small amount labelled data. Methods: 158 patients had suspicious lesions delineated on MRI based on bp-MRI, 64 patients had ILs delineated on MRI based on whole mount prostatectomy specimen sections, 40 patients were unlabelled. A non-local Mask R-CNN was proposed to improve the segmentat…
Washington University（华盛顿大学）；Washington University School of Medicine（华盛顿大学医学院）
Purpose: The research is to develop a novel CNN-based adversarial deep learning method to improve and expedite the multi-organ semantic segmentation of CT images, and to generate accurate contours on pelvic CT images. Methods: Planning CT and structure datasets for 120 patients with intact prostate cancer were retrospectively selected and divided for 10-fold cross-validation. The proposed adversarial multi-residual multi-scale pooling Markov Random Field (MRF) enhanced network (ARPM-net) implements an adversarial training scheme. A segmentation network and a discriminator network were trained …
University of Toronto（多伦多大学）；Lunenfeld-Tanenbaum Research Institute, Sinai Health System（Sinai Health System 伦内菲尔德-塔嫩鲍姆研究所）；Brigham and Women’s Hospital（布莱根妇女医院）；The Hospital for Sick Children（SickKids 医院）
The segmentation of prostate whole gland and transition zone in Diffusion Weighted MRI (DWI) are the first step in designing computer-aided detection algorithms for prostate cancer. However, variations in MRI acquisition parameters and scanner manufacturing result in different appearances of prostate tissue in the images. Convolutional neural networks (CNNs) which have shown to be successful in various medical image analysis tasks including segmentation are typically sensitive to the variations in imaging parameters. This sensitivity leads to poor segmentation performance of CNNs trained on a …
City University of Hong Kong（香港城市大学）；University College London（伦敦大学学院）
Dice similarity coefficient (DSC) and Hausdorff distance (HD) are widely used for evaluating medical image segmentation. They have also been criticised, when reported alone, for their unclear or even misleading clinical interpretation. DSCs may also differ substantially from HDs, due to boundary smoothness or multiple regions of interest (ROIs) within a subject. More importantly, either metric can also have a nonlinear, non-monotonic relationship with outcomes based on Type 1 and 2 errors, designed for specific clinical decisions that use the resulting segmentation. Whilst cases causing disagr…
DeepBayesFlow: A Bayesian Structured Variational Framework for Generalizable Prostate Segmentation via Expressive Posteriors and SDE-Girsanov Uncertainty Modeling
Building robust deep learning-based models requires diverse training data, ideally from several sources. However, these datasets cannot be combined easily because of patient privacy concerns or regulatory hurdles, especially if medical data is involved. Federated learning (FL) is a way to train machine learning models without the need for centralized datasets. Each FL client trains on their local data while only sharing model parameters with a global server that aggregates the parameters from all clients. At the same time, each client's data can exhibit differences and inconsistencies due to t…
We propose a novel automatic method for accurate segmentation of the prostate in T2-weighted magnetic resonance imaging (MRI). Our method is based on convolutional neural networks (CNNs). Because of the large variability in the shape, size, and appearance of the prostate and the scarcity of annotated training data, we suggest training two separate CNNs. A global CNN will determine a prostate bounding box, which is then resampled and sent to a local CNN for accurate delineation of the prostate boundary. This way, the local CNN can effectively learn to segment the fine details that distinguish t…
University of Shanghai for Science and Technology（上海理工大学）；Tongji University（同济大学）；National University of Singapore（新加坡国立大学）；Shanghai Fire Corps Hospital（上海消防总队医院）；Shanghai Tenth People’s Hospital（上海市第十人民医院）
Automatic segmentation of the prostate cancer from the multi-modal magnetic resonance images is of critical importance for the initial staging and prognosis of patients. However, how to use the multi-modal image features more efficiently is still a challenging problem in the field of medical image segmentation. In this paper, we develop a cross-modal self-attention distillation network by fully exploiting the encoded information of the intermediate layers from different modalities, and the extracted attention maps of different modalities enable the model to transfer the significant spatial inf…
Empirical Analysis of a Segmentation Foundation Model in Prostate Imaging
Weill Cornell Medicine（威尔康奈尔医学院）；Martinos Center for Biomedical Imaging, Massachusetts General Hospital（麻省总医院马丁诺斯生物医学成像中心）；Harvard Medical School（哈佛医学院）；Massachusetts Institute of Technology（麻省理工学院）；Cornell University（康奈尔大学）；Cornell Tech（康奈尔理工学院）
