Segment Any Medical Model Extended

The Segment Anything Model (SAM) has drawn significant attention from researchers who work on medical image segmentation because of its generalizability. However, researchers have found that SAM may have limited performance on medical images compared to state-of-the-art non-foundation models. Regardless, the community sees potential in extending, fine-tuning, modifying, and evaluating SAM for analysis of medical imaging. An increasing number of works have been published focusing on the mentioned four directions, where variants of SAM are proposed. To this end, a unified platform helps push the boundary of the foundation model for medical images, facilitating the use, modification, and validation of SAM and its variants in medical image segmentation. In this work, we introduce SAMM Extended (SAMME), a platform that integrates new SAM variant models, adopts faster communication protocols, accommodates new interactive modes, and allows for fine-tuning of subcomponents of the models. These features can expand the potential of foundation models like SAM, and the results can be translated to applications such as image-guided therapy, mixed reality interaction, robotic navigation, and data augmentation.

DeepEdit: Deep Editable Learning for Interactive Segmentation of 3D Medical Images

Automatic segmentation of medical images is a key step for diagnostic and interventional tasks. However, achieving this requires large amounts of annotated volumes, which can be tedious and time-consuming task for expert annotators. In this paper, we introduce DeepEdit, a deep learning-based method for volumetric medical image annotation, that allows automatic and semi-automatic segmentation, and click-based refinement. DeepEdit combines the power of two methods: a non-interactive (i.e. automatic segmentation using nnU-Net, UNET or UNETR) and an interactive segmentation method (i.e. DeepGrow), into a single deep learning model. It allows easy integration of uncertainty-based ranking strategies (i.e. aleatoric and epistemic uncertainty computation) and active learning. We propose and implement a method for training DeepEdit by using standard training combined with user interaction simulation. Once trained, DeepEdit allows clinicians to quickly segment their datasets by using the algorithm in auto segmentation mode or by providing clicks via a user interface (i.e. 3D Slicer, OHIF). We show the value of DeepEdit through evaluation on the PROSTATEx dataset for prostate/prostatic lesions and the Multi-Atlas Labeling Beyond the Cranial Vault (BTCV) dataset for abdominal CT segmentation, using state-of-the-art network architectures as baseline for comparison. DeepEdit could reduce the time and effort annotating 3D medical images compared to DeepGrow alone. Source code is available at https://github.com/Project-MONAI/MONAILabel

MONAI: An open-source framework for deep learning in healthcare

Artificial Intelligence (AI) is having a tremendous impact across most areas of science. Applications of AI in healthcare have the potential to improve our ability to detect, diagnose, prognose, and intervene on human disease. For AI models to be used clinically, they need to be made safe, reproducible and robust, and the underlying software framework must be aware of the particularities (e.g. geometry, physiology, physics) of medical data being processed. This work introduces MONAI, a freely available, community-supported, and consortium-led PyTorch-based framework for deep learning in healthcare. MONAI extends PyTorch to support medical data, with a particular focus on imaging, and provide purpose-specific AI model architectures, transformations and utilities that streamline the development and deployment of medical AI models. MONAI follows best practices for software-development, providing an easy-to-use, robust, well-documented, and well-tested software framework. MONAI preserves the simple, additive, and compositional approach of its underlying PyTorch libraries. MONAI is being used by and receiving contributions from research, clinical and industrial teams from around the world, who are pursuing applications spanning nearly every aspect of healthcare.

MONAI Label: A framework for AI-assisted Interactive Labeling of 3D Medical Images

The lack of annotated datasets is a major challenge in training new task-specific supervised AI algorithms as manual annotation is expensive and time-consuming. To address this problem, we present MONAI Label, a free and open-source platform that facilitates the development of AI-based applications that aim at reducing the time required to annotate 3D medical image datasets. Through MONAI Label researchers can develop annotation applications focusing on their domain of expertise. It allows researchers to readily deploy their apps as services, which can be made available to clinicians via their preferred user-interface. Currently, MONAI Label readily supports locally installed (3DSlicer) and web-based (OHIF) frontends, and offers two Active learning strategies to facilitate and speed up the training of segmentation algorithms. MONAI Label allows researchers to make incremental improvements to their labeling apps by making them available to other researchers and clinicians alike. Lastly, MONAI Label provides sample labeling apps, namely DeepEdit and DeepGrow, demonstrating dramatically reduced annotation times.

Semi-Automatic Algorithm for Breast MRI Lesion Segmentation Using Marker-Controlled Watershed Transformation

Magnetic resonance imaging (MRI) is an effective imaging modality for identifying and localizing breast lesions in women. Accurate and precise lesion segmentation using a computer-aided-diagnosis (CAD) system, is a crucial step in evaluating tumor volume and in the quantification of tumor characteristics. However, this is a challenging task, since breast lesions have sophisticated shape, topological structure, and high variance in their intensity distribution across patients. In this paper, we propose a novel marker-controlled watershed transformation-based approach, which uses the brightest pixels in a region of interest (determined by experts) as markers to overcome this challenge, and accurately segment lesions in breast MRI. The proposed approach was evaluated on 106 lesions, which includes 64 malignant and 42 benign cases. Segmentation results were quantified by comparison with ground truth labels, using the Dice similarity coefficient (DSC) and Jaccard index (JI) metrics. The proposed method achieved an average Dice coefficient of 0.7808$\pm$0.1729 and Jaccard index of 0.6704$\pm$0.2167. These results illustrate that the proposed method shows promise for future work related to the segmentation and classification of benign and malignant breast lesions.