Skeleton Supervised Airway Segmentation

Fully-supervised airway segmentation has accomplished significant triumphs over the years in aiding pre-operative diagnosis and intra-operative navigation. However, full voxel-level annotation constitutes a labor-intensive and time-consuming task, often plagued by issues such as missing branches, branch annotation discontinuity, or erroneous edge delineation. label-efficient solutions for airway extraction are rarely explored yet primarily demanding in medical practice. To this end, we introduce a novel skeleton-level annotation (SkA) tailored to the airway, which simplifies the annotation workflow while enhancing annotation consistency and accuracy, preserving the complete topology. Furthermore, we propose a skeleton-supervised learning framework to achieve accurate airway segmentation. Firstly, a dual-stream buffer inference is introduced to realize initial label propagation from SkA, avoiding the collapse of direct learning from SkA. Then, we construct a geometry-aware dual-path propagation framework (GDP) to further promote complementary propagation learning, composed of hard geometry-aware propagation learning and soft geometry-aware propagation guidance. Experiments reveal that our proposed framework outperforms the competing methods with SKA, which amounts to only 1.96% airways, and achieves comparable performance with the baseline model that is fully supervised with 100% airways, demonstrating its significant potential in achieving label-efficient segmentation for other tubular structures, such as vessels.

GDDS: Pulmonary Bronchioles Segmentation with Group Deep Dense Supervision

Airway segmentation, especially bronchioles segmentation, is an important but challenging task because distal bronchus are sparsely distributed and of a fine scale. Existing neural networks usually exploit sparse topology to learn the connectivity of bronchioles and inefficient shallow features to capture such high-frequency information, leading to the breakage or missed detection of individual thin branches. To address these problems, we contribute a new bronchial segmentation method based on Group Deep Dense Supervision (GDDS) that emphasizes fine-scale bronchioles segmentation in a simple-but-effective manner. First, Deep Dense Supervision (DDS) is proposed by constructing local dense topology skillfully and implementing dense topological learning on a specific shallow feature layer. GDDS further empowers the shallow features with better perception ability to detect bronchioles, even the ones that are not easily discernible to the naked eye. Extensive experiments on the BAS benchmark dataset have shown that our method promotes the network to have a high sensitivity in capturing fine-scale branches and outperforms state-of-the-art methods by a large margin (+12.8 % in BD and +8.8 % in TD) while only introducing a small number of extra parameters.