Weakly Supervised Segmentation of Vertebral Bodies with Iterative Slice-propagation

Vertebral body (VB) segmentation is an important preliminary step towards medical visual diagnosis for spinal diseases. However, most previous works require pixel/voxel-wise strong supervisions, which is expensive, tedious and time-consuming for experts to annotate. In this paper, we propose a Weakly supervised Iterative Spinal Segmentation (WISS) method leveraging only four corner landmark weak labels on a single sagittal slice to achieve automatic volumetric segmentation from CT images for VBs. WISS first segments VBs on an annotated sagittal slice in an iterative self-training manner. This self-training method alternates between training and refining labels in the training set. Then WISS proceeds to segment the whole VBs slice by slice with a slice-propagation method to obtain volumetric segmentations. We evaluate the performance of WISS on a private spinal metastases CT dataset and the public lumbar CT dataset. On the first dataset, WISS achieves distinct improvements with regard to two different backbones. For the second dataset, WISS achieves dice coefficients of $91.7\%$ and $83.7\%$ for mid-sagittal slices and 3D CT volumes, respectively, saving a lot of labeling costs and only sacrificing a little segmentation performance.

Learning-based Bone Quality Classification Method for Spinal Metastasis

Spinal metastasis is the most common disease in bone metastasis and may cause pain, instability and neurological injuries. Early detection of spinal metastasis is critical for accurate staging and optimal treatment. The diagnosis is usually facilitated with Computed Tomography (CT) scans, which requires considerable efforts from well-trained radiologists. In this paper, we explore a learning-based automatic bone quality classification method for spinal metastasis based on CT images. We simultaneously take the posterolateral spine involvement classification task into account, and employ multi-task learning (MTL) technique to improve the performance. MTL acts as a form of inductive bias which helps the model generalize better on each task by sharing representations between related tasks. Based on the prior knowledge that the mixed type can be viewed as both blastic and lytic, we model the task of bone quality classification as two binary classification sub-tasks, i.e., whether blastic and whether lytic, and leverage a multiple layer perceptron to combine their predictions. In order to make the model more robust and generalize better, self-paced learning is adopted to gradually involve from easy to more complex samples into the training process. The proposed learning-based method is evaluated on a proprietary spinal metastasis CT dataset. At slice level, our method significantly outperforms an 121-layer DenseNet classifier in sensitivities by $+12.54\%$, $+7.23\%$ and $+29.06\%$ for blastic, mixed and lytic lesions, respectively, meanwhile $+12.33\%$, $+23.21\%$ and $+34.25\%$ at vertebrae level.