Multi-organ segmentation is a critical problem in medical image analysis due to its great value for computer-aided diagnosis, computer-aided surgery, and radiation therapy. Although fully-supervised segmentation methods can achieve good performance, they usually require a large amount of 3D data, such as CT scans, with voxel-wised annotations which are usually difficult, expensive, and slow to obtain. By contrast, large unannotated datasets of CT images are available. Inspired by the well-known semi-supervised learning framework co-training, we propose multi-planar co-training (MPCT), to generate more reliable pseudo-labels by enforcing consistency among multiple planes, i.e., saggital, coronal, and axial planes, of 3D unlabeled medical data, which play a vital role in our framework. Empirical results show that generating pseudo-labels by the multi-planar fusion rather than a single plane leads to a significant performance gain. We evaluate our approach on a new collected dataset and show that MPCT boosts the performance of a typical segmentation model, fully convolutional networks, by a large margin, when only a small set of labeled 3D data is available, i.e., 77.49 vs. 73.14 .
Early studies of abdominal organ segmentation focused on atlas-based methods @cite_34 @cite_10 @cite_20 . The frameworks are usually problematic because 1) they are not able to capture the large inter-subject variations of abdominal regions and 2) computational time is tightly dependent on the number of atlases. Recently, learning-based approaches with relatively large dataset have been introduced for multi-organ segmentation @cite_41 @cite_3 @cite_18 . Especially, deep Convolutional Neural Networks (CNNs) based methods have achieved a great success in the medical image segmentation @cite_21 @cite_5 @cite_19 @cite_32 @cite_2 @cite_14 @cite_48 in the last few years. Compared with multi-atlas-based approaches, CNNs based methods are generally more efficient and accurate. CNNs based methods for multi-organ segmentation can be divided into two major categories: 3D CNNs @cite_21 @cite_5 @cite_19 based and 2D CNNs @cite_32 @cite_2 @cite_14 @cite_48 based. 3D CNNs usually adopt the sliding-window strategy to avoid the problem, leading to high time complexity. Compared with 3D CNNs, 2D CNNs based algorithms can be directly end-to-end trained using 2D deep networks, which is less time-consuming.
@cite_18 @cite_14 @cite_41 @cite_48 @cite_21 @cite_32 @cite_3 @cite_19 @cite_2 @cite_5 @cite_34 @cite_10 @cite_20
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The purpose of this study is to evaluate and compare the performance of modern deep learning techniques for automatically recognizing and segmenting multiple organ regions on 3D CT images. CT image segmentation is one of the important task in medical image analysis and is still very challenging. Deep learning approaches have demonstrated the capability of scene recognition and semantic segmentation on nature images and have been used to address segmentation problems of medical images. Although several works showed promising results of CT image segmentation by using deep learning approaches, there is no comprehensive evaluation of segmentation performance of the deep learning on segmenting multiple organs on different portions of CT scans. In this paper, we evaluated and compared the segmentation performance of two different deep learning approaches that used 2D- and 3D deep convolutional neural networks (CNN) without- and with a pre-processing step. A conventional approach that presents the state-of-the-art performance of CT image segmentation without deep learning was also used for comparison. A dataset that includes 240 CT images scanned on different portions of human bodies was used for performance evaluation. The maximum number of 17 types of organ regions in each CT scan were segmented automatically and compared to the human annotations by using ratio of intersection over union (IU) as the criterion. The experimental results demonstrated the IUs of the segmentation results had a mean value of 79 and 67 by averaging 17 types of organs that segmented by a 3D- and 2D deep CNN, respectively. All the results of the deep learning approaches showed a better accuracy and robustness than the conventional segmentation method that used probabilistic atlas and graph-cut methods. The effectiveness and the usefulness of deep learning approaches were demonstrated for solving multiple organs segmentation problem on 3D CT images. Abstract 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 of abdominal regions 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. More specifically, 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. Intuitively, OAN reduces the effect of the complex background by focusing attention so that each organ only needs to be discriminated from its local background. RCs are added to the first stage to give the lower layers more semantic information thereby enabling them to adapt to the sizes of different organs. Our networks are trained on 2D views (slices) enabling us to use holistic information and allowing efficient computation (compared to using 3D patches). To compensate for the limited cross-sectional information of the original 3D volumetric CT, e.g., the connectivity between neighbor slices, 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 by 4-fold cross-validation and computed Dice–Sorensen similarity coefficients (DSC) and surface distances for evaluating our estimates of the 13 structures. Our experiments show that the proposed approach gives strong results and outperforms 2D- and 3D-patch based state-of-the-art methods in terms of DSC and mean surface distances. Incorporation of prior knowledge about organ shape and location is key to improve performance of image analysis approaches. In particular, priors can be useful in cases where images are corrupted and contain artefacts due to limitations in image acquisition. The highly constrained nature of anatomical objects can be well captured with learning-based techniques. However, in most recent and promising techniques such as CNN-based segmentation it is not obvious how to incorporate such prior knowledge. State-of-the-art methods operate as pixel-wise classifiers where the training objectives do not incorporate the structure and inter-dependencies of the output. To overcome this limitation, we propose a generic training strategy that incorporates anatomical prior knowledge into CNNs through a new regularisation model, which is trained end-to-end. The new framework encourages models to follow the global anatomical properties of the underlying anatomy ( e.g. shape, label structure) via learnt non-linear representations of the shape. We show that the proposed approach can be easily adapted to different analysis tasks ( e.g. image enhancement, segmentation) and improve the prediction accuracy of the state-of-the-art models. The applicability of our approach is shown on multi-modal cardiac data sets and public benchmarks. In addition, we demonstrate how the learnt deep models of 3-D shapes can be interpreted and used as biomarkers for classification of cardiac pathologies. Recent advances in 3D fully convolutional networks (FCN) have made it feasible to produce dense voxel-wise predictions of full volumetric images. In this work, we show that a multi-class 3D FCN trained on manually labeled CT scans of seven abdominal structures (artery, vein, liver, spleen, stomach, gallbladder, and pancreas) can achieve competitive segmentation results, while avoiding the need for handcrafting features or training organ-specific models. To this end, we propose a two-stage, coarse-to-fine approach that trains an FCN model to roughly delineate the organs of interest in the first stage (seeing @math 40 of the voxels within a simple, automatically generated binary mask of the patient's body). We then use these predictions of the first-stage FCN to define a candidate region that will be used to train a second FCN. This step reduces the number of voxels the FCN has to classify to @math 10 while maintaining a recall high of @math 99 . This second-stage FCN can now focus on more detailed segmentation of the organs. We respectively utilize training and validation sets consisting of 281 and 50 clinical CT images. Our hierarchical approach provides an improved Dice score of 7.5 percentage points per organ on average in our validation set. We furthermore test our models on a completely unseen data collection acquired at a different hospital that includes 150 CT scans with three anatomical labels (liver, spleen, and pancreas). In such challenging organs as the pancreas, our hierarchical approach improves the mean Dice score from 68.5 to 82.2 , achieving the highest reported average score on this dataset.