Morphology-Enhanced CAM-Guided SAM for weakly supervised Breast Lesion Segmentation

Breast cancer diagnosis challenges both patients and clinicians, with early detection being crucial for effective treatment. Ultrasound imaging plays a key role in this, but its utility is hampered by the need for precise lesion segmentation-a task that is both time-consuming and labor-intensive. To address these challenges, we propose a new framework: a morphology-enhanced, Class Activation Map (CAM)-guided model, which is optimized using a computer vision foundation model known as SAM. This innovative framework is specifically designed for weakly supervised lesion segmentation in early-stage breast ultrasound images. Our approach uniquely leverages image-level annotations, which removes the requirement for detailed pixel-level annotation. Initially, we perform a preliminary segmentation using breast lesion morphology knowledge. Following this, we accurately localize lesions by extracting semantic information through a CAM-based heatmap. These two elements are then fused together, serving as a prompt to guide the SAM in performing refined segmentation. Subsequently, post-processing techniques are employed to rectify topological errors made by the SAM. Our method not only simplifies the segmentation process but also attains accuracy comparable to supervised learning methods that rely on pixel-level annotation. Our framework achieves a Dice score of 74.39% on the test set, demonstrating compareable performance with supervised learning methods. Additionally, it outperforms a supervised learning model, in terms of the Hausdorff distance, scoring 24.27 compared to Deeplabv3+'s 32.22. These experimental results showcase its feasibility and superior performance in integrating weakly supervised learning with SAM. The code is made available at: https://github.com/YueXin18/MorSeg-CAM-SAM.