Dual-scale Enhanced and Cross-generative Consistency Learning for Semi-supervised Polyp Segmentation

Automatic polyp segmentation plays a crucial role in the early diagnosis and treatment of colorectal cancer (CRC). However, existing methods heavily rely on fully supervised training, which requires a large amount of labeled data with time-consuming pixel-wise annotations. Moreover, accurately segmenting polyps poses challenges due to variations in shape, size, and location. To address these issues, we propose a novel Dual-scale Enhanced and Cross-generative consistency learning framework for semi-supervised polyp Segmentation (DEC-Seg) from colonoscopy images. First, we propose a Cross-level Feature Aggregation (CFA) module that integrates cross-level adjacent layers to enhance the feature representation ability across different resolutions. To address scale variation, we present a scale-enhanced consistency constraint, which ensures consistency in the segmentation maps generated from the same input image at different scales. This constraint helps handle variations in polyp sizes and improves the robustness of the model. Additionally, we design a scale-aware perturbation consistency scheme to enhance the robustness of the mean teacher model. Furthermore, we propose a cross-generative consistency scheme, in which the original and perturbed images can be reconstructed using cross-segmentation maps. This consistency constraint allows us to mine effective feature representations and boost the segmentation performance. To produce more accurate segmentation maps, we propose a Dual-scale Complementary Fusion (DCF) module that integrates features from two scale-specific decoders operating at different scales. Extensive experimental results on five benchmark datasets demonstrate the effectiveness of our DEC-Seg against other state-of-the-art semi-supervised segmentation approaches. The implementation code will be released at https://github.com/taozh2017/DECSeg.

SegRap2023: A Benchmark of Organs-at-Risk and Gross Tumor Volume Segmentation for Radiotherapy Planning of Nasopharyngeal Carcinoma

Radiation therapy is a primary and effective NasoPharyngeal Carcinoma (NPC) treatment strategy. The precise delineation of Gross Tumor Volumes (GTVs) and Organs-At-Risk (OARs) is crucial in radiation treatment, directly impacting patient prognosis. Previously, the delineation of GTVs and OARs was performed by experienced radiation oncologists. Recently, deep learning has achieved promising results in many medical image segmentation tasks. However, for NPC OARs and GTVs segmentation, few public datasets are available for model development and evaluation. To alleviate this problem, the SegRap2023 challenge was organized in conjunction with MICCAI2023 and presented a large-scale benchmark for OAR and GTV segmentation with 400 Computed Tomography (CT) scans from 200 NPC patients, each with a pair of pre-aligned non-contrast and contrast-enhanced CT scans. The challenge's goal was to segment 45 OARs and 2 GTVs from the paired CT scans. In this paper, we detail the challenge and analyze the solutions of all participants. The average Dice similarity coefficient scores for all submissions ranged from 76.68\% to 86.70\%, and 70.42\% to 73.44\% for OARs and GTVs, respectively. We conclude that the segmentation of large-size OARs is well-addressed, and more efforts are needed for GTVs and small-size or thin-structure OARs. The benchmark will remain publicly available here: https://segrap2023.grand-challenge.org

Segment Anything Model-guided Collaborative Learning Network for Scribble-supervised Polyp Segmentation

Polyp segmentation plays a vital role in accurately locating polyps at an early stage, which holds significant clinical importance for the prevention of colorectal cancer. Various polyp segmentation methods have been developed using fully-supervised deep learning techniques. However, pixel-wise annotation for polyp images by physicians during the diagnosis is both time-consuming and expensive. Moreover, visual foundation models such as the Segment Anything Model (SAM) have shown remarkable performance. Nevertheless, directly applying SAM to medical segmentation may not produce satisfactory results due to the inherent absence of medical knowledge. In this paper, we propose a novel SAM-guided Collaborative Learning Network (SAM-CLNet) for scribble-supervised polyp segmentation, enabling a collaborative learning process between our segmentation network and SAM to boost the model performance. Specifically, we first propose a Cross-level Enhancement and Aggregation Network (CEA-Net) for weakly-supervised polyp segmentation. Within CEA-Net, we propose a Cross-level Enhancement Module (CEM) that integrates the adjacent features to enhance the representation capabilities of different resolution features. Additionally, a Feature Aggregation Module (FAM) is employed to capture richer features across multiple levels. Moreover, we present a box-augmentation strategy that combines the segmentation maps generated by CEA-Net with scribble annotations to create more precise prompts. These prompts are then fed into SAM, generating segmentation SAM-guided masks, which can provide additional supervision to train CEA-Net effectively. Furthermore, we present an Image-level Filtering Mechanism to filter out unreliable SAM-guided masks. Extensive experimental results show that our SAM-CLNet outperforms state-of-the-art weakly-supervised segmentation methods.