Guidelines for Cerebrovascular Segmentation: Managing Imperfect Annotations in the context of Semi-Supervised Learning

Segmentation in medical imaging is an essential and often preliminary task in the image processing chain, driving numerous efforts towards the design of robust segmentation algorithms. Supervised learning methods achieve excellent performances when fed with a sufficient amount of labeled data. However, such labels are typically highly time-consuming, error-prone and expensive to produce. Alternatively, semi-supervised learning approaches leverage both labeled and unlabeled data, and are very useful when only a small fraction of the dataset is labeled. They are particularly useful for cerebrovascular segmentation, given that labeling a single volume requires several hours for an expert. In addition to the challenge posed by insufficient annotations, there are concerns regarding annotation consistency. The task of annotating the cerebrovascular tree is inherently ambiguous. Due to the discrete nature of images, the borders and extremities of vessels are often unclear. Consequently, annotations heavily rely on the expert subjectivity and on the underlying clinical objective. These discrepancies significantly increase the complexity of the segmentation task for the model and consequently impair the results. Consequently, it becomes imperative to provide clinicians with precise guidelines to improve the annotation process and construct more uniform datasets. In this article, we investigate the data dependency of deep learning methods within the context of imperfect data and semi-supervised learning, for cerebrovascular segmentation. Specifically, this study compares various state-of-the-art semi-supervised methods based on unsupervised regularization and evaluates their performance in diverse quantity and quality data scenarios. Based on these experiments, we provide guidelines for the annotation and training of cerebrovascular segmentation models.

Cascaded multitask U-Net using topological loss for vessel segmentation and centerline extraction

Vessel segmentation and centerline extraction are two crucial preliminary tasks for many computer-aided diagnosis tools dealing with vascular diseases. Recently, deep-learning based methods have been widely applied to these tasks. However, classic deep-learning approaches struggle to capture the complex geometry and specific topology of vascular networks, which is of the utmost importance in most applications. To overcome these limitations, the clDice loss, a topological loss that focuses on the vessel centerlines, has been recently proposed. This loss requires computing, with a proposed soft-skeleton algorithm, the skeletons of both the ground truth and the predicted segmentation. However, the soft-skeleton algorithm provides suboptimal results on 3D images, which makes the clDice hardly suitable on 3D images. In this paper, we propose to replace the soft-skeleton algorithm by a U-Net which computes the vascular skeleton directly from the segmentation. We show that our method provides more accurate skeletons than the soft-skeleton algorithm. We then build upon this network a cascaded U-Net trained with the clDice loss to embed topological constraints during the segmentation. The resulting model is able to predict both the vessel segmentation and centerlines with a more accurate topology.