Abstract:Segmenting organs in CT scan images is a necessary process for multiple downstream medical image analysis tasks. Currently, manual CT scan segmentation by radiologists is prevalent, especially for organs like the pancreas, which requires a high level of domain expertise for reliable segmentation due to factors like small organ size, occlusion, and varying shapes. When resorting to automated pancreas segmentation, these factors translate to limited reliable labeled data to train effective segmentation models. Consequently, the performance of contemporary pancreas segmentation models is still not within acceptable ranges. To improve that, we propose M3BUNet, a fusion of MobileNet and U-Net neural networks, equipped with a novel Mean-Max (MM) attention that operates in two stages to gradually segment pancreas CT images from coarse to fine with mask guidance for object detection. This approach empowers the network to surpass segmentation performance achieved by similar network architectures and achieve results that are on par with complex state-of-the-art methods, all while maintaining a low parameter count. Additionally, we introduce external contour segmentation as a preprocessing step for the coarse stage to assist in the segmentation process through image standardization. For the fine segmentation stage, we found that applying a wavelet decomposition filter to create multi-input images enhances pancreas segmentation performance. We extensively evaluate our approach on the widely known NIH pancreas dataset and MSD pancreas dataset. Our approach demonstrates a considerable performance improvement, achieving an average Dice Similarity Coefficient (DSC) value of up to 89.53% and an Intersection Over Union (IOU) score of up to 81.16 for the NIH pancreas dataset, and 88.60% DSC and 79.90% IOU for the MSD Pancreas dataset.