Chunli Li

Ke Yan, Xiaoli Yin, Yingda Xia et al.

Liver tumor segmentation and classification are important tasks in computer aided diagnosis. We aim to address three problems: liver tumor screening and preliminary diagnosis in non-contrast computed tomography (CT), and differential diagnosis in dynamic contrast-enhanced CT. A novel framework named Pixel-Lesion-pAtient Network (PLAN) is proposed. It uses a mask transformer to jointly segment and classify each lesion with improved anchor queries and a foreground-enhanced sampling loss. It also has an image-wise classifier to effectively aggregate global information and predict patient-level diagnosis. A large-scale multi-phase dataset is collected containing 939 tumor patients and 810 normal subjects. 4010 tumor instances of eight types are extensively annotated. On the non-contrast tumor screening task, PLAN achieves 95% and 96% in patient-level sensitivity and specificity. On contrast-enhanced CT, our lesion-level detection precision, recall, and classification accuracy are 92%, 89%, and 86%, outperforming widely used CNN and transformers for lesion segmentation. We also conduct a reader study on a holdout set of 250 cases. PLAN is on par with a senior human radiologist, showing the clinical significance of our results.

Jiacheng Hao, Xiaoming Zhang, Wei Liu et al.

Focal liver lesions (FLL) are common clinical findings during physical examination. Early diagnosis and intervention of liver malignancies are crucial to improving patient survival. Although the current 3D segmentation paradigm can accurately detect lesions, it faces limitations in distinguishing between malignant and benign liver lesions, primarily due to its inability to differentiate subtle variations between different lesions. Furthermore, existing methods predominantly rely on specialized imaging modalities such as multi-phase contrast-enhanced CT and magnetic resonance imaging, whereas non-contrast CT (NCCT) is more prevalent in routine abdominal imaging. To address these limitations, we propose PLUS, a plug-and-play framework that enhances FLL analysis on NCCT images for arbitrary 3D segmentation models. In extensive experiments involving 8,651 patients, PLUS demonstrated a significant improvement with existing methods, improving the lesion-level F1 score by 5.66%, the malignant patient-level F1 score by 6.26%, and the benign patient-level F1 score by 4.03%. Our results demonstrate the potential of PLUS to improve malignant FLL screening using widely available NCCT imaging substantially.