Cited by 507Medical Image Segmentation TechniquesAdvanced Neural Network ApplicationsBrain Tumor Detection and Classification

The DOI matches its Crossref record; 75 of the 90 references it cites were found in a registry or an index; none of the 70 sources its claims cite is checked for support yet.

DeepIGeoS: A Deep Interactive Geodesic Framework for Medical Image Segmentation

Open access
Wang, Guotai, Zuluaga, Maria A., Li, Wenqi, Pratt, Rosalind, Patel, Premal A., Aertsen, Michael, Doel, Tom, David, Anna L., Deprest, Jan, Ourselin, Sebastien, Vercauteren, Tom·2019·IEEE Transactions on Pattern Analysis and Machine Intelligence

Abstract

Accurate medical image segmentation is essential for diagnosis, surgical planning and many other applications. Convolutional Neural Networks (CNNs) have become the state-of-the-art automatic segmentation methods. However, fully automatic results may still need to be refined to become accurate and robust enough for clinical use. We propose a deep learning-based interactive segmentation method to improve the results obtained by an automatic CNN and to reduce user interactions during refinement for higher accuracy. We use one CNN to obtain an initial automatic segmentation, on which user interactions are added to indicate mis-segmentations. Another CNN takes as input the user interactions with the initial segmentation and gives a refined result. We propose to combine user interactions with CNNs through geodesic distance transforms, and propose a resolution-preserving network that gives a better dense prediction. In addition, we integrate user interactions as hard constraints into a back-propagatable Conditional Random Field. We validated the proposed framework in the context of 2D placenta segmentation from fetal MRI and 3D brain tumor segmentation from FLAIR images. Experimental results show our method achieves a large improvement from automatic CNNs, and obtains comparable and even higher accuracy with fewer user interventions and less time compared with traditional interactive methods.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

DeepIGeoS is a two-stage interactive segmentation framework in which a CNN proposes an initial segmentation and a second CNN refines it using user clicks/scribbles encoded as geodesic distance maps, with a trainable CRF that can enforce user interactions as hard constraints. It improved over automatic CNNs and achieved comparable or higher accuracy with fewer interactions and less user time than traditional interactive methods in 2D fetal MRI placenta and 3D brain tumor segmentation.

Key findings

  • In 2D placenta segmentation, 2D P-Net + CRF-Net(f) reached Dice 85.86 ± 11.67% and ASSD 1.85 ± 1.30 pixels; after interactive refinement, 2D R-Net + CRF-Net(fu) reached Dice 89.31 ± 5.33% and ASSD 1.22 ± 0.55 pixels.
  • In 3D brain tumor segmentation, 3D P-Net + CRF-Net(f) reached Dice 87.55 ± 6.72% and ASSD 2.04 ± 1.70 pixels; after refinement, 3D R-Net + CRF-Net(fu) reached Dice 89.93 ± 6.49% and ASSD 1.43 ± 1.16 pixels.
  • Geodesic distance maps outperformed Euclidean distance maps for refinement, and CRF-Net(fu) further improved results; CRF-Net(f) with freeform pairwise potentials outperformed Dense CRF and CRF-Net(g) in the reported comparisons.
  • Compared with traditional interactive methods, DeepIGeoS required far fewer user interactions and less user time; for 3D brain tumor segmentation, user time was about one third of that for GeoS and ITK-SNAP.

Methods

  • Two-stage pipeline: P-Net produces an automatic initial segmentation; R-Net takes the original image, initial segmentation, and user interactions converted into geodesic distance maps to refine the result.
  • Networks use a resolution-preserving dilated-convolution structure adapted from VGG-16, with multi-scale feature concatenation; a back-propagatable CRF-Net uses freeform pairwise potentials and, in R-Net, user scribbles as hard constraints.
  • Data: 2D placenta from T2-weighted fetal MRI of 25 pregnant women, with 17 volumes/624 slices for training, 3 volumes/122 slices for validation, and 5 volumes/179 slices for testing; 3D brain tumor from the 2015 BraTS training set, using FLAIR images only, with 234 cases for training and 40 for testing. Evaluation used Dice and ASSD, with Student’s t-test for significance.

Limitations

  • The paper does not include a dedicated limitations section; it states that the framework can be extended to deal with multiple organs in the future.
  • Evident from the experiments: validation is limited to two binary segmentation tasks, and the 3D experiment uses only FLAIR images and segments only the whole tumor, not multi-label or multi-modality tumor subregions.
  • Evident from the text: R-Net training uses simulated user interactions generated from mis-segmented regions, which may not fully match real user behavior.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1109/tpami.2018.2840695

Cites

75 of 75 references verified0 citation errors · 0 not checkable

Statistics

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Verification

Claims the paper makes

0 of 70 cited sources checked · 0 supported · 0 flagged

Show all 40 claims

  • It may state two separate claims as one. 31
  • The quote only partly states this claim. 6
  • Probably not a substantial claim. 26
  • Borderline: one of the tests for a substantial claim is unclear. 1
54 of 54
  • The paper relies on this without support.

    Poor image quality, large variations among patients, inhomogeneous appearances from pathology, and variability of protocols among clinicians lead to limitations of automatic segmentation.

    “This is typically due to poor image quality (with noise, partial volume effect, artifacts and low contrast), large variations among patients, inhomogeneous appearances brought by pathology, and variability of protocols among clinicians leading to different definitions of a given structure boundary.”
  • The paper relies on this without support.

    Providing manual annotations for segmentation is time-consuming and labor-intensive.

    “As providing manual annotations for segmentation is time-consuming and labor-intensive, an efficient interactive segmentation tool is of great importance for practical use.”
  • The paper relies on this without support.

    The initial automatic segmentation from P-Net is high-quality.

    “the method starts with a high-quality automatic segmentation”
  • The paper relies on this without support.

    Simulated user interactions (random clicks in mis-segmented regions) are representative of real user interactions for training R-Net.

    “we automatically simulate user interactions to train R-Net with CRF-Net(fu)”
  • The paper relies on this without support.

    The manually delineated ground truth is accurate.

    “The ground truth was manually delineated by an experienced Radiologist.”
  • The paper relies on this without support.

    Automatic brain tumor segmentation remains technically challenging because tumor size, shape, and localization vary among patients and boundaries between adjacent structures are often ambiguous.

    “automatic brain tumor segmentation remains technically challenging because 1) the size, shape, and localization of brain tumors have considerable variations among patients; 2) the boundaries between adjacent structures are often ambiguous.”
  • The paper relies on this without support.

    Segmentation of brain tumors can provide better volumetric measurements and therefore has enormous potential value for improved diagnosis, treatment planning, and follow-up of individual patients.

    “Segmentation of brain tumors can provide better volumetric measurements and therefore has enormous potential value for improved diagnosis, treatment planning, and follow-up of individual patients.”
7 of 7

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Citations

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  1. payet, 2010, (RF)^2 – random forest random field, Proc Neural Inf Process Syst Conf, 1885

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Metadata

Authors
Wang, G., Zuluaga, M. A., Li, W., Pratt, R., Patel, P. A., Aertsen, M., Doel, T., David, A. L., Deprest, J., Ourselin, S., & Vercauteren, T.
Affiliations
  • Wellcome / EPSRC Centre for Interventional and Surgical Sciences (GB)
  • University College London (GB)
  • KU Leuven (BE)
Corresponding author
Wang, Guotai
Venue
IEEE Transactions on Pattern Analysis and Machine Intelligence
Published
2019-07-01
Volume
41
Issue
7
Pages
1559-1572
ISSN
  • 0162-8828 (ISSN-L)
  • 2160-9292
  • 1939-3539
OpenAlex
W2732931556
Cited by
502
References
90
Citations by year
2026: 47 · 2025: 74 · 2024: 64 · 2023: 75 · 2022: 76 · 2021: 82 · 2020: 42 · 2019: 31
FWCI
20.76
Type
journal article
Language
en
Open access
Locations
  • IEEE Transactions on Pattern Analysis and Machine Intelligence (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • arXiv (Cornell University) (submittedVersion)
  • Lirias (submittedVersion, other-oa)
  • UCL Discovery (University College London) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion, cc-by)
  • arXiv (Cornell University)
Funders
  • Wellcome Trust (WT101957)
  • Engineering and Physical Sciences Research Council (NS/A000027/1, EP/H046410/1, EP/J020990/1, EP/K005278)
  • Wellcome/EPSRC (203145Z/16/Z)
  • National Institute for Health Research (NIHR BRC UCLH/UCL)
  • Royal Society (RG160569)
Topics
  • Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Medical Image Segmentation Techniques
  • Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Advanced Neural Network Applications
  • Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Brain Tumor Detection and Classification
Keywords
interactive segmentation, medical image segmentation, user interaction, conditional random fields, placenta segmentation, fetal MRI, brain tumor segmentation, FLAIR MRI, dense prediction, segmentation refinement
MeSH terms
Brain Neoplasms, Female, Humans, Image Interpretation, Computer-Assisted, Magnetic Resonance Imaging, Placenta, Pregnancy, Neural Networks, Computer, Imaging, Three-Dimensional

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