RadSAM: Segmenting 3D radiological images with a 2D promptable model

Medical image segmentation is a crucial and time-consuming task in clinical care, where mask precision is extremely important. The Segment Anything Model (SAM) offers a promising approach, as it provides an interactive interface based on visual prompting and edition to refine an initial segmentation. This model has strong generalization capabilities, does not rely on predefined classes, and adapts to diverse objects; however, it is pre-trained on natural images and lacks the ability to process medical data effectively. In addition, this model is built for 2D images, whereas a whole medical domain is based on 3D images, such as CT and MRI. Recent adaptations of SAM for medical imaging are based on 2D models, thus requiring one prompt per slice to segment 3D objects, making the segmentation process tedious. They also lack important features such as editing. To bridge this gap, we propose RadSAM, a novel method for segmenting 3D objects with a 2D model from a single prompt. In practice, we train a 2D model using noisy masks as initial prompts, in addition to bounding boxes and points. We then use this novel prompt type with an iterative inference pipeline to reconstruct the 3D mask slice-by-slice. We introduce a benchmark to evaluate the model's ability to segment 3D objects in CT images from a single prompt and evaluate the models' out-of-domain transfer and edition capabilities. We demonstrate the effectiveness of our approach against state-of-the-art models on this benchmark using the AMOS abdominal organ segmentation dataset.

ONCOPILOT: A Promptable CT Foundation Model For Solid Tumor Evaluation

Carcinogenesis is a proteiform phenomenon, with tumors emerging in various locations and displaying complex, diverse shapes. At the crucial intersection of research and clinical practice, it demands precise and flexible assessment. However, current biomarkers, such as RECIST 1.1's long and short axis measurements, fall short of capturing this complexity, offering an approximate estimate of tumor burden and a simplistic representation of a more intricate process. Additionally, existing supervised AI models face challenges in addressing the variability in tumor presentations, limiting their clinical utility. These limitations arise from the scarcity of annotations and the models' focus on narrowly defined tasks. To address these challenges, we developed ONCOPILOT, an interactive radiological foundation model trained on approximately 7,500 CT scans covering the whole body, from both normal anatomy and a wide range of oncological cases. ONCOPILOT performs 3D tumor segmentation using visual prompts like point-click and bounding boxes, outperforming state-of-the-art models (e.g., nnUnet) and achieving radiologist-level accuracy in RECIST 1.1 measurements. The key advantage of this foundation model is its ability to surpass state-of-the-art performance while keeping the radiologist in the loop, a capability that previous models could not achieve. When radiologists interactively refine the segmentations, accuracy improves further. ONCOPILOT also accelerates measurement processes and reduces inter-reader variability, facilitating volumetric analysis and unlocking new biomarkers for deeper insights. This AI assistant is expected to enhance the precision of RECIST 1.1 measurements, unlock the potential of volumetric biomarkers, and improve patient stratification and clinical care, while seamlessly integrating into the radiological workflow.