Benchmarking the CoW with the TopCoW Challenge: Topology-Aware Anatomical Segmentation of the Circle of Willis for CTA and MRA

The Circle of Willis (CoW) is an important network of arteries connecting major circulations of the brain. Its vascular architecture is believed to affect the risk, severity, and clinical outcome of serious neuro-vascular diseases. However, characterizing the highly variable CoW anatomy is still a manual and time-consuming expert task. The CoW is usually imaged by two angiographic imaging modalities, magnetic resonance angiography (MRA) and computed tomography angiography (CTA), but there exist limited public datasets with annotations on CoW anatomy, especially for CTA. Therefore we organized the TopCoW Challenge in 2023 with the release of an annotated CoW dataset and invited submissions worldwide for the CoW segmentation task, which attracted over 140 registered participants from four continents. TopCoW dataset was the first public dataset with voxel-level annotations for CoW's 13 vessel components, made possible by virtual-reality (VR) technology. It was also the first dataset with paired MRA and CTA from the same patients. TopCoW challenge aimed to tackle the CoW characterization problem as a multiclass anatomical segmentation task with an emphasis on topological metrics. The top performing teams managed to segment many CoW components to Dice scores around 90%, but with lower scores for communicating arteries and rare variants. There were also topological mistakes for predictions with high Dice scores. Additional topological analysis revealed further areas for improvement in detecting certain CoW components and matching CoW variant's topology accurately. TopCoW represented a first attempt at benchmarking the CoW anatomical segmentation task for MRA and CTA, both morphologically and topologically.

BoostMIS: Boosting Medical Image Semi-supervised Learning with Adaptive Pseudo Labeling and Informative Active Annotation

In this paper, we propose a novel semi-supervised learning (SSL) framework named BoostMIS that combines adaptive pseudo labeling and informative active annotation to unleash the potential of medical image SSL models: (1) BoostMIS can adaptively leverage the cluster assumption and consistency regularization of the unlabeled data according to the current learning status. This strategy can adaptively generate one-hot "hard" labels converted from task model predictions for better task model training. (2) For the unselected unlabeled images with low confidence, we introduce an Active learning (AL) algorithm to find the informative samples as the annotation candidates by exploiting virtual adversarial perturbation and model's density-aware entropy. These informative candidates are subsequently fed into the next training cycle for better SSL label propagation. Notably, the adaptive pseudo-labeling and informative active annotation form a learning closed-loop that are mutually collaborative to boost medical image SSL. To verify the effectiveness of the proposed method, we collected a metastatic epidural spinal cord compression (MESCC) dataset that aims to optimize MESCC diagnosis and classification for improved specialist referral and treatment. We conducted an extensive experimental study of BoostMIS on MESCC and another public dataset COVIDx. The experimental results verify our framework's effectiveness and generalisability for different medical image datasets with a significant improvement over various state-of-the-art methods.