QCResUNet: Joint Subject-level and Voxel-level Segmentation Quality Prediction

Deep learning has made significant strides in automated brain tumor segmentation from magnetic resonance imaging (MRI) scans in recent years. However, the reliability of these tools is hampered by the presence of poor-quality segmentation outliers, particularly in out-of-distribution samples, making their implementation in clinical practice difficult. Therefore, there is a need for quality control (QC) to screen the quality of the segmentation results. Although numerous automatic QC methods have been developed for segmentation quality screening, most were designed for cardiac MRI segmentation, which involves a single modality and a single tissue type. Furthermore, most prior works only provided subject-level predictions of segmentation quality and did not identify erroneous parts segmentation that may require refinement. To address these limitations, we proposed a novel multi-task deep learning architecture, termed QCResUNet, which produces subject-level segmentation-quality measures as well as voxel-level segmentation error maps for each available tissue class. To validate the effectiveness of the proposed method, we conducted experiments on assessing its performance on evaluating the quality of two distinct segmentation tasks. First, we aimed to assess the quality of brain tumor segmentation results. For this task, we performed experiments on one internal and two external datasets. Second, we aimed to evaluate the segmentation quality of cardiac Magnetic Resonance Imaging (MRI) data from the Automated Cardiac Diagnosis Challenge. The proposed method achieved high performance in predicting subject-level segmentation-quality metrics and accurately identifying segmentation errors on a voxel basis. This has the potential to be used to guide human-in-the-loop feedback to improve segmentations in clinical settings.

AgileFormer: Spatially Agile Transformer UNet for Medical Image Segmentation

In the past decades, deep neural networks, particularly convolutional neural networks, have achieved state-of-the-art performance in a variety of medical image segmentation tasks. Recently, the introduction of the vision transformer (ViT) has significantly altered the landscape of deep segmentation models. There has been a growing focus on ViTs, driven by their excellent performance and scalability. However, we argue that the current design of the vision transformer-based UNet (ViT-UNet) segmentation models may not effectively handle the heterogeneous appearance (e.g., varying shapes and sizes) of objects of interest in medical image segmentation tasks. To tackle this challenge, we present a structured approach to introduce spatially dynamic components to the ViT-UNet. This adaptation enables the model to effectively capture features of target objects with diverse appearances. This is achieved by three main components: \textbf{(i)} deformable patch embedding; \textbf{(ii)} spatially dynamic multi-head attention; \textbf{(iii)} deformable positional encoding. These components were integrated into a novel architecture, termed AgileFormer. AgileFormer is a spatially agile ViT-UNet designed for medical image segmentation. Experiments in three segmentation tasks using publicly available datasets demonstrated the effectiveness of the proposed method. The code is available at \href{https://github.com/sotiraslab/AgileFormer}{https://github.com/sotiraslab/AgileFormer}.