Haoshen Li

Zifan Chen, Xinyu Nan, Jiazheng Li et al.

Volumetric segmentation is important in medical imaging, but current methods face challenges like requiring lots of manual annotations and being tailored to specific tasks, which limits their versatility. General segmentation models used for natural images don't perform well with the unique features of medical images. There's a strong need for an adaptable approach that can effectively handle different 3D medical structures and imaging modalities. In this study, we present PAM (Propagating Anything Model), a segmentation approach that uses a 2D prompt, like a bounding box or sketch, to create a complete 3D segmentation of medical image volumes. PAM works by modeling relationships between slices, maintaining information flow across the 3D structure. It combines a CNN-based UNet for processing within slices and a Transformer-based attention module for propagating information between slices, leading to better generalizability across various imaging modalities. PAM significantly outperformed existing models like MedSAM and SegVol, with an average improvement of over 18.1% in dice similarity coefficient (DSC) across 44 medical datasets and various object types. It also showed stable performance despite prompt deviations and different propagation setups, and faster inference speeds compared to other models. PAM's one-view prompt design made it more efficient, reducing interaction time by about 63.6% compared to two-view prompts. Thanks to its focus on structural relationships, PAM handled unseen and complex objects well, showing a unique ability to generalize to new situations. PAM represents an advancement in medical image segmentation, effectively reducing the need for extensive manual work and specialized training. Its adaptability makes it a promising tool for more automated and reliable analysis in clinical settings.

Yirui Wang, Qinji Yu, Ke Yan et al.

Lymph node (LN) assessment is a critical, indispensable yet very challenging task in the routine clinical workflow of radiology and oncology. Accurate LN analysis is essential for cancer diagnosis, staging, and treatment planning. Finding scatteredly distributed, low-contrast clinically relevant LNs in 3D CT is difficult even for experienced physicians under high inter-observer variations. Previous automatic LN detection works typically yield limited recall and high false positives (FPs) due to adjacent anatomies with similar image intensities, shapes, or textures (vessels, muscles, esophagus, etc). In this work, we propose a new LN DEtection TRansformer, named LN-DETR, to achieve more accurate performance. By enhancing the 2D backbone with a multi-scale 2.5D feature fusion to incorporate 3D context explicitly, more importantly, we make two main contributions to improve the representation quality of LN queries. 1) Considering that LN boundaries are often unclear, an IoU prediction head and a location debiased query selection are proposed to select LN queries of higher localization accuracy as the decoder query's initialization. 2) To reduce FPs, query contrastive learning is employed to explicitly reinforce LN queries towards their best-matched ground-truth queries over unmatched query predictions. Trained and tested on 3D CT scans of 1067 patients (with 10,000+ labeled LNs) via combining seven LN datasets from different body parts (neck, chest, and abdomen) and pathologies/cancers, our method significantly improves the performance of previous leading methods by > 4-5% average recall at the same FP rates in both internal and external testing. We further evaluate on the universal lesion detection task using NIH DeepLesion benchmark, and our method achieves the top performance of 88.46% averaged recall across 0.5 to 4 FPs per image, compared with other leading reported results.