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.

Deep Learning-based Framework for Automatic Cranial Defect Reconstruction and Implant Modeling

The goal of this work is to propose a robust, fast, and fully automatic method for personalized cranial defect reconstruction and implant modeling. We propose a two-step deep learning-based method using a modified U-Net architecture to perform the defect reconstruction, and a dedicated iterative procedure to improve the implant geometry, followed by automatic generation of models ready for 3-D printing. We propose a cross-case augmentation based on imperfect image registration combining cases from different datasets. We perform ablation studies regarding different augmentation strategies and compare them to other state-of-the-art methods. We evaluate the method on three datasets introduced during the AutoImplant 2021 challenge, organized jointly with the MICCAI conference. We perform the quantitative evaluation using the Dice and boundary Dice coefficients, and the Hausdorff distance. The average Dice coefficient, boundary Dice coefficient, and the 95th percentile of Hausdorff distance are 0.91, 0.94, and 1.53 mm respectively. We perform an additional qualitative evaluation by 3-D printing and visualization in mixed reality to confirm the implant's usefulness. We propose a complete pipeline that enables one to create the cranial implant model ready for 3-D printing. The described method is a greatly extended version of the method that scored 1st place in all AutoImplant 2021 challenge tasks. We freely release the source code, that together with the open datasets, makes the results fully reproducible. The automatic reconstruction of cranial defects may enable manufacturing personalized implants in a significantly shorter time, possibly allowing one to perform the 3-D printing process directly during a given intervention. Moreover, we show the usability of the defect reconstruction in mixed reality that may further reduce the surgery time.

Automatic Nonrigid Histological Image Registration with Adaptive Multistep Algorithm

In this paper, we present a short description of the method proposed to ANHIR challenge organized jointly with the IEEE ISBI 2019 conference. We propose a method consisting of preprocessing, initial alignment, nonrigid registration algorithms and a method to automatically choose the best result. The method turned out to be robust (99.792% robustness) and accurate (0.38% average median rTRE). The main drawback of the proposed method is relatively high computation time. However, this aspect can be easily improved by cleaning the code and proposing a GPU implementation.