Lipeng Ning

Guoping Xu, Jayaram K. Udupa, Jax Luo et al.

Medical image segmentation has advanced rapidly over the past two decades, largely driven by deep learning, which has enabled accurate and efficient delineation of cells, tissues, organs, and pathologies across diverse imaging modalities. This progress raises a fundamental question: to what extent have current models overcome persistent challenges, and what gaps remain? In this work, we provide an in-depth review of medical image segmentation, tracing its progress and key developments over the past decade. We examine core principles, including multiscale analysis, attention mechanisms, and the integration of prior knowledge, across the encoder, bottleneck, skip connections, and decoder components of segmentation networks. Our discussion is organized around seven key dimensions: (1) the shift from supervised to semi-/unsupervised learning, (2) the transition from organ segmentation to lesion-focused tasks, (3) advances in multi-modality integration and domain adaptation, (4) the role of foundation models and transfer learning, (5) the move from deterministic to probabilistic segmentation, (6) the progression from 2D to 3D and 4D segmentation, and (7) the trend from model invocation to segmentation agents. Together, these perspectives provide a holistic overview of the trajectory of deep learning-based medical image segmentation and aim to inspire future innovation. To support ongoing research, we maintain a continually updated repository of relevant literature and open-source resources at https://github.com/apple1986/medicalSegReview

Jun Lyu, Lipeng Ning, William Consagra et al.

High-resolution whole-brain in vivo MR imaging at mesoscale resolutions remains challenging due to long scan durations, motion artifacts, and limited signal-to-noise ratio (SNR). This study proposes Rotating-view super-resolution (ROVER)-MRI, an unsupervised framework based on multi-scale implicit neural representations (INR), enabling efficient recovery of fine anatomical details from multi-view thick-slice acquisitions. ROVER-MRI employs coordinate-based neural networks to implicitly and continuously encode image structures at multiple spatial scales, simultaneously modeling anatomical continuity and correcting inter-view motion through an integrated registration mechanism. Validation on ex-vivo monkey brain data and multiple in-vivo human datasets demonstrates substantially improved reconstruction performance compared to bicubic interpolation and state-of-the-art regularized least-squares super-resolution reconstruction (LS-SRR) with 2-fold reduction in scan time. Notably, ROVER-MRI achieves an unprecedented whole-brain in-vivo T2-weighted imaging at 180 micron isotropic resolution in only 17 minutes of scan time on a 7T scanner with 22.4% lower relative error compared to LS-SRR. We also demonstrate improved SNR using ROVER-MRI compared to a time-matched 3D GRE acquisition. Quantitative results on several datasets demonstrate better sharpness of the reconstructed images with ROVER-MRI for different super-resolution factors (5 to 11). These findings highlight ROVER-MRI's potential as a rapid, accurate, and motion-resilient mesoscale imaging solution, promising substantial advantages for neuroimaging studies.