Human and AI collaboration for pulmonary nodule segmentation

Medical expert annotators are scarce, and blind reliance on artificial intelligence (AI) can be misleading, motivating approaches in which humans, particularly junior medical trainees or even non-medical personnel, collaborate with AI to achieve robust medical segmentation. Although the Segment Anything Model (SAM) shows promise for general-purpose image segmentation, its performance in human-AI collaboration for specialized medical tasks has not been thoroughly evaluated. Here we present Hi-Seg, a human-in-the-loop segmentation framework for pulmonary nodules built on SAM. Humans iteratively refine prompts through trial-and-error learning and semantic reasoning, progressively guiding SAM toward higher-quality masks. Using chest CT scans from 1,179 patients across 12 centers, we conducted the first large-scale external validation of collaborative human-SAM segmentation. Across all annotator groups, Hi-Seg achieved a mean Dice score of almost 85%, outperforming five state-of-the-art deep learning models by 10-22% and 13 SAM variants by 1-29%. Hi-Seg improved segmentation accuracy while reducing annotation time for medical annotators, and briefly trained non-medical annotators achieved performance comparable to that of the junior medical student. These findings suggest that human-in-the-loop segmentation can reduce clinician workload, enable scalable crowdsourced annotation, and transform clinical workflows by facilitating the safe and efficient integration of foundation models into routine clinical practice.

Alleviating Hyperparameter-Tuning Burden in SVM Classifiers for Pulmonary Nodules Diagnosis with Multi-Task Bayesian Optimization

In the field of non-invasive medical imaging, radiomic features are utilized to measure tumor characteristics. However, these features can be affected by the techniques used to discretize the images, ultimately impacting the accuracy of diagnosis. To investigate the influence of various image discretization methods on diagnosis, it is common practice to evaluate multiple discretization strategies individually. This approach often leads to redundant and time-consuming tasks such as training predictive models and fine-tuning hyperparameters separately. This study examines the feasibility of employing multi-task Bayesian optimization to accelerate the hyperparameters search for classifying benign and malignant pulmonary nodules using RBF SVM. Our findings suggest that multi-task Bayesian optimization significantly accelerates the search for hyperparameters in comparison to a single-task approach. To the best of our knowledge, this is the first investigation to utilize multi-task Bayesian optimization in a critical medical context.