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.

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Integrity signals

Registry

Crossref · 10.1109/tpami.2018.2840695

Cites

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Statistics

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Figures

Fig. 1. Overview of the proposed interactive segmentation framework with two stages. Stage 1: P-Net automatically proposes an initial segmentation. Stage 2: R-Net refines the segmentation with user interactions indicating mis-segmentations. CRF-Net(f) is our proposed back-propagatable CRF that uses freeform pairwise potentials. It is extended to be CRF-Net(fu) that employs user interactions as hard constraints.
Fig. 1. Overview of the proposed interactive segmentation framework with two stages. Stage 1: P-Net automatically proposes an initial segmentation. Stage 2: R-Net refines the segmentation with user interactions indicating mis-segmentations. CRF-Net(f) is our proposed back-propagatable CRF that uses freeform pairwise potentials. It is extended to be CRF-Net(fu) that employs user interactions as hard constraints.CC BY · PubMed Central
Fig. 2. Input of R-Net in Stage 2. (a) The user provides clicks/scribbles to correct foreground (red) and background (cyan) on the initial automatic segmentation. (d) and (e) are geodesic distance maps based on foreground and background interactions, respectively. The original image (b) is combined with the initial automatic segmentation (c) and the geodesic distance maps (d), (e) by channel-concatenation and used as the input of R-Net.
Fig. 2. Input of R-Net in Stage 2. (a) The user provides clicks/scribbles to correct foreground (red) and background (cyan) on the initial automatic segmentation. (d) and (e) are geodesic distance maps based on foreground and background interactions, respectively. The original image (b) is combined with the initial automatic segmentation (c) and the geodesic distance maps (d), (e) by channel-concatenation and used as the input of R-Net.CC BY · PubMed Central
Fig. 3. The CNN structure of 2D/3D P-Net with CRF-Net(f). The parameters of convolution layers are (kernel size, output channels, dilation) in dark blue rectangles. Block 1 to block 6 are resolution-preserving. 2D/3D R-Net uses the same structure as 2D/3D P-Net except its input has three additional channels shown in Fig. 2 and the CRF-Net(f) is replaced by the CRF-Net(fu) (Section 3.3).
Fig. 3. The CNN structure of 2D/3D P-Net with CRF-Net(f). The parameters of convolution layers are (kernel size, output channels, dilation) in dark blue rectangles. Block 1 to block 6 are resolution-preserving. 2D/3D R-Net uses the same structure as 2D/3D P-Net except its input has three additional channels shown in Fig. 2 and the CRF-Net(f) is replaced by the CRF-Net(fu) (Section 3.3).CC BY · PubMed Central
Fig. 4. The Pairwise-Net for pairwise potential function f(f˜ij,dij). f˜ij is the difference of features between a pixel pair i and j. dij is the euclidean distance between them.
Fig. 4. The Pairwise-Net for pairwise potential function f(f˜ij,dij). f˜ij is the difference of features between a pixel pair i and j. dij is the euclidean distance between them.CC BY · PubMed Central
Fig. 5. Simulated user interactions on training images for placenta (a) and brain tumor (b, c). Green: automatic segmentation given by P-Net with CRF-Net(f). Yellow: ground truth. Red (cyan): simulated clicks on under-segmentation (over-segmentation).
Fig. 5. Simulated user interactions on training images for placenta (a) and brain tumor (b, c). Green: automatic segmentation given by P-Net with CRF-Net(f). Yellow: ground truth. Red (cyan): simulated clicks on under-segmentation (over-segmentation).CC BY · PubMed Central
Fig. 6. Visual comparison of different networks in Stage 1 of 2D placenta segmentation. The last row shows interactively refined results by DeepIGeoS.
Fig. 6. Visual comparison of different networks in Stage 1 of 2D placenta segmentation. The last row shows interactively refined results by DeepIGeoS.CC BY · PubMed Central
Fig. 7. Visual comparison of different CRFs in Stage 1 of 2D placenta segmentation. The last row shows interactively refined results by DeepIGeoS.
Fig. 7. Visual comparison of different CRFs in Stage 1 of 2D placenta segmentation. The last row shows interactively refined results by DeepIGeoS.CC BY · PubMed Central
Fig. 8. Visual comparison of different refinement methods in Stage 2 of 2D placenta segmentation. The first column shows the initial automatic segmentation obtained by 2D P-Net + CRF-Net(f), on which user interactions are added for refinement. The remaining columns show refined results. 2D R-Net(Euc) is a counterpart of the proposed 2D R-Net and it uses euclidean distance. White arrows show the difference in local details.
Fig. 8. Visual comparison of different refinement methods in Stage 2 of 2D placenta segmentation. The first column shows the initial automatic segmentation obtained by 2D P-Net + CRF-Net(f), on which user interactions are added for refinement. The remaining columns show refined results. 2D R-Net(Euc) is a counterpart of the proposed 2D R-Net and it uses euclidean distance. White arrows show the difference in local details.CC BY · PubMed Central
Fig. 9. Visual comparison of DeepIGeoS and other interactive methods for 2D placenta segmentation. The first row shows initial scribbles (except for DeepIGeoS) and the resulting segmentation. The second row shows final refined results with the entire set of scribbles. The user decided on the level of interaction required to achieve a visually acceptable result.
Fig. 9. Visual comparison of DeepIGeoS and other interactive methods for 2D placenta segmentation. The first row shows initial scribbles (except for DeepIGeoS) and the resulting segmentation. The second row shows final refined results with the entire set of scribbles. The user decided on the level of interaction required to achieve a visually acceptable result.CC BY · PubMed Central
Fig. 10. Quantitative comparison of 2D placenta segmentation by different interactive methods in terms of Dice, ASSD, total interactions (scribble length) and user time.
Fig. 10. Quantitative comparison of 2D placenta segmentation by different interactive methods in terms of Dice, ASSD, total interactions (scribble length) and user time.CC BY · PubMed Central
Fig. 11. Visual comparison of different networks in Stage 1 of 3D brain tumor segmentation. The last row shows interactively refined results by DeepIGeoS.
Fig. 11. Visual comparison of different networks in Stage 1 of 3D brain tumor segmentation. The last row shows interactively refined results by DeepIGeoS.CC BY · PubMed Central
Fig. 12. Visual comparison of different CRFs in Stage 1 of 3D brain tumor segmentation. The last column shows interactively refined results by DeepIGeoS.
Fig. 12. Visual comparison of different CRFs in Stage 1 of 3D brain tumor segmentation. The last column shows interactively refined results by DeepIGeoS.CC BY · PubMed Central
Fig. 13. Visual comparison of different refinement methods in Stage 2 of 3D brain tumor segmentation. The initial segmentation is obtained by 3D P-Net + CRF-Net(f), on which user interactions are given. 3D R-Net(Euc) is a counterpart of the proposed 3D R-Net and it uses euclidean distance.
Fig. 13. Visual comparison of different refinement methods in Stage 2 of 3D brain tumor segmentation. The initial segmentation is obtained by 3D P-Net + CRF-Net(f), on which user interactions are given. 3D R-Net(Euc) is a counterpart of the proposed 3D R-Net and it uses euclidean distance.CC BY · PubMed Central
Fig. 14. Visual comparison of 3D brain tumor segmentation using GeoS, ITK-SNAP, and DeepIGeoS that is based on 3D P-Net.
Fig. 14. Visual comparison of 3D brain tumor segmentation using GeoS, ITK-SNAP, and DeepIGeoS that is based on 3D P-Net.CC BY · PubMed Central
Fig. 15. Quantitative evaluation of 3D brain tumor segmentation by DeepIGeoS, GeoS and ITK-SNAP.
Fig. 15. Quantitative evaluation of 3D brain tumor segmentation by DeepIGeoS, GeoS and ITK-SNAP.CC BY · PubMed Central

Verification

Claims the paper makes

42 Not checked yet · 34 Own result · 9 Own interpretation · 6 No basis given · 3 Own method

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  • 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.”
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Citations

Cites

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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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