Alexander Broersen

Xiaotong Zhang, Alexander Broersen, Gonnie CM van Erp et al.

The preoperative planning of liver surgery relies on Couinaud segmentation from computed tomography (CT) images, to reduce the risk of bleeding and guide the resection procedure. Using 3D point-based representations, rather than voxelizing the CT volume, has the benefit of preserving the physical resolution of the CT. However, point-based representations need prior knowledge of the liver vessel structure, which is time consuming to acquire. Here, we propose a point-based method for Couinaud segmentation, without explicitly providing the prior liver vessel structure. To allow the model to learn this anatomical liver vessel structure, we add a graph reasoning module on top of the point features. This adds implicit anatomical information to the model, by learning affinities across point neighborhoods. Our method is competitive on the MSD and LiTS public datasets in Dice coefficient and average surface distance scores compared to four pioneering point-based methods. Our code is available at https://github.com/ZhangXiaotong015/GrPn.

Xiaotong Zhang, Alexander Broersen, Gonnie CM van Erp et al.

Improving connectivity and completeness are the most challenging aspects of liver vessel segmentation, especially for small vessels. These challenges require both learning the continuous vessel geometry, and focusing on small vessel detection. However, current methods do not explicitly address these two aspects and cannot generalize well when constrained by inconsistent annotations. Here, we take advantage of the generalization of the diffusion model and explicitly integrate connectivity and completeness in our diffusion-based segmentation model. Specifically, we use a graph-attention module that adds knowledge about vessel geometry, and thus adds continuity. Additionally, we perform the graph-attention at multiple-scales, thus focusing on small liver vessels. Our method outperforms eight state-of-the-art medical segmentation methods on two public datasets: 3D-ircadb-01 and LiVS. Our code is available at https://github.com/ZhangXiaotong015/GATSegDiff.

Xiaotong Zhang, Alexander Broersen, Gonnie CM van Erp et al.

Liver-vessel segmentation is an essential task in the pre-operative planning of liver resection. State-of-the-art 2D or 3D convolution-based methods focusing on liver vessel segmentation on 2D CT cross-sectional views, which do not take into account the global liver-vessel topology. To maintain this global vessel topology, we rely on the underlying physics used in the CT reconstruction process, and apply this to liver-vessel segmentation. Concretely, we introduce the concept of top-k maximum intensity projections, which mimics the CT reconstruction by replacing the integral along each projection direction, with keeping the top-k maxima along each projection direction. We use these top-k maximum projections to condition a diffusion model and generate 3D liver-vessel trees. We evaluate our 3D liver-vessel segmentation on the 3D-ircadb-01 dataset, and achieve the highest Dice coefficient, intersection-over-union (IoU), and Sensitivity scores compared to prior work.