Benchmark of Segmentation Techniques for Pelvic Fracture in CT and X-ray: Summary of the PENGWIN 2024 Challenge

The segmentation of pelvic fracture fragments in CT and X-ray images is crucial for trauma diagnosis, surgical planning, and intraoperative guidance. However, accurately and efficiently delineating the bone fragments remains a significant challenge due to complex anatomy and imaging limitations. The PENGWIN challenge, organized as a MICCAI 2024 satellite event, aimed to advance automated fracture segmentation by benchmarking state-of-the-art algorithms on these complex tasks. A diverse dataset of 150 CT scans was collected from multiple clinical centers, and a large set of simulated X-ray images was generated using the DeepDRR method. Final submissions from 16 teams worldwide were evaluated under a rigorous multi-metric testing scheme. The top-performing CT algorithm achieved an average fragment-wise intersection over union (IoU) of 0.930, demonstrating satisfactory accuracy. However, in the X-ray task, the best algorithm attained an IoU of 0.774, highlighting the greater challenges posed by overlapping anatomical structures. Beyond the quantitative evaluation, the challenge revealed methodological diversity in algorithm design. Variations in instance representation, such as primary-secondary classification versus boundary-core separation, led to differing segmentation strategies. Despite promising results, the challenge also exposed inherent uncertainties in fragment definition, particularly in cases of incomplete fractures. These findings suggest that interactive segmentation approaches, integrating human decision-making with task-relevant information, may be essential for improving model reliability and clinical applicability.

Learning Generalizable Features for Tibial Plateau Fracture Segmentation Using Masked Autoencoder and Limited Annotations

Accurate automated segmentation of tibial plateau fractures (TPF) from computed tomography (CT) requires large amounts of annotated data to train deep learning models, but obtaining such annotations presents unique challenges. The process demands expert knowledge to identify diverse fracture patterns, assess severity, and account for individual anatomical variations, making the annotation process highly time-consuming and expensive. Although semi-supervised learning methods can utilize unlabeled data, existing approaches often struggle with the complexity and variability of fracture morphologies, as well as limited generalizability across datasets. To tackle these issues, we propose an effective training strategy based on masked autoencoder (MAE) for the accurate TPF segmentation in CT. Our method leverages MAE pretraining to capture global skeletal structures and fine-grained fracture details from unlabeled data, followed by fine-tuning with a small set of labeled data. This strategy reduces the dependence on extensive annotations while enhancing the model's ability to learn generalizable and transferable features. The proposed method is evaluated on an in-house dataset containing 180 CT scans with TPF. Experimental results demonstrate that our method consistently outperforms semi-supervised methods, achieving an average Dice similarity coefficient (DSC) of 95.81%, average symmetric surface distance (ASSD) of 1.91mm, and Hausdorff distance (95HD) of 9.42mm with only 20 annotated cases. Moreover, our method exhibits strong transferability when applying to another public pelvic CT dataset with hip fractures, highlighting its potential for broader applications in fracture segmentation tasks.

A Review of Image Processing Methods in Prostate Ultrasound

Prostate cancer (PCa) poses a significant threat to men's health, with early diagnosis being crucial for improving prognosis and reducing mortality rates. Transrectal ultrasound (TRUS) plays a vital role in the diagnosis and image-guided intervention of PCa.To facilitate physicians with more accurate and efficient computer-assisted diagnosis and interventions, many image processing algorithms in TRUS have been proposed and achieved state-of-the-art performance in several tasks, including prostate gland segmentation, prostate image registration, PCa classification and detection, and interventional needle detection.The rapid development of these algorithms over the past two decades necessitates a comprehensive summary. In consequence, this survey provides a systematic analysis of this field, outlining the evolution of image processing methods in the context of TRUS image analysis and meanwhile highlighting their relevant contributions. Furthermore, this survey discusses current challenges and suggests future research directions to possibly advance this field further.