PSFHS Challenge Report: Pubic Symphysis and Fetal Head Segmentation from Intrapartum Ultrasound Images

Segmentation of the fetal and maternal structures, particularly intrapartum ultrasound imaging as advocated by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) for monitoring labor progression, is a crucial first step for quantitative diagnosis and clinical decision-making. This requires specialized analysis by obstetrics professionals, in a task that i) is highly time- and cost-consuming and ii) often yields inconsistent results. The utility of automatic segmentation algorithms for biometry has been proven, though existing results remain suboptimal. To push forward advancements in this area, the Grand Challenge on Pubic Symphysis-Fetal Head Segmentation (PSFHS) was held alongside the 26th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI 2023). This challenge aimed to enhance the development of automatic segmentation algorithms at an international scale, providing the largest dataset to date with 5,101 intrapartum ultrasound images collected from two ultrasound machines across three hospitals from two institutions. The scientific community's enthusiastic participation led to the selection of the top 8 out of 179 entries from 193 registrants in the initial phase to proceed to the competition's second stage. These algorithms have elevated the state-of-the-art in automatic PSFHS from intrapartum ultrasound images. A thorough analysis of the results pinpointed ongoing challenges in the field and outlined recommendations for future work. The top solutions and the complete dataset remain publicly available, fostering further advancements in automatic segmentation and biometry for intrapartum ultrasound imaging.

Intrapartum Ultrasound Image Segmentation of Pubic Symphysis and Fetal Head Using Dual Student-Teacher Framework with CNN-ViT Collaborative Learning

The segmentation of the pubic symphysis and fetal head (PSFH) constitutes a pivotal step in monitoring labor progression and identifying potential delivery complications. Despite the advances in deep learning, the lack of annotated medical images hinders the training of segmentation. Traditional semi-supervised learning approaches primarily utilize a unified network model based on Convolutional Neural Networks (CNNs) and apply consistency regularization to mitigate the reliance on extensive annotated data. However, these methods often fall short in capturing the discriminative features of unlabeled data and in delineating the long-range dependencies inherent in the ambiguous boundaries of PSFH within ultrasound images. To address these limitations, we introduce a novel framework, the Dual-Student and Teacher Combining CNN and Transformer (DSTCT), which synergistically integrates the capabilities of CNNs and Transformers. Our framework comprises a Vision Transformer (ViT) as the teacher and two student mod ls one ViT and one CNN. This dual-student setup enables mutual supervision through the generation of both hard and soft pseudo-labels, with the consistency in their predictions being refined by minimizing the classifier determinacy discrepancy. The teacher model further reinforces learning within this architecture through the imposition of consistency regularization constraints. To augment the generalization abilities of our approach, we employ a blend of data and model perturbation techniques. Comprehensive evaluations on the benchmark dataset of the PSFH Segmentation Grand Challenge at MICCAI 2023 demonstrate our DSTCT framework outperformed ten contemporary semi-supervised segmentation methods. Code available at https://github.com/jjm1589/DSTCT.