A generic approach to pathological lung segmentation

Awais Mansoor; Ulas Bagci; Ziyue Xu; Brent Foster; Kenneth N. Olivier; Jason M. Elinoff; Anthony F. Suffredini; Jayaram K. Udupa; Daniel J. Mollura

IEEE Transactions on Medical Imaging, 33(12), 2293–2310

Abstract

In this study, we propose a novel pathological lung segmentation method that takes into account neighbor prior constraints and a novel pathology recognition system. Our proposed framework has two stages; during stage one, we adapted the fuzzy connectedness (FC) image segmentation algorithm to perform initial lung parenchyma extraction. In parallel, we estimate the lung volume using rib-cage information without explicitly delineating lungs. This rudimentary, but intelligent lung volume estimation system allows comparison of volume differences between rib cage and FC based lung volume measurements. Significant volume difference indicates the presence of pathology, which invokes the second stage of the proposed framework for the refinement of segmented lung. In stage two, texture-based features are utilized to detect abnormal imaging patterns (consolidations, ground glass, interstitial thickening, tree-inbud, honeycombing, nodules, and micro-nodules) that might have been missed during the first stage of the algorithm. This refinement stage is further completed by a novel neighboring anatomy-guided segmentation approach to include abnormalities with weak textures, and pleura regions. We evaluated the accuracy and efficiency of the proposed method on more than 400 CT scans with the presence of a wide spectrum of abnormalities. To our best of knowledge, this is the first study to evaluate all abnormal imaging patterns in a single segmentation framework. The quantitative results show that our pathological lung segmentation method improves on current standards because of its high sensitivity and specificity and may have considerable potential to enhance the performance of routine clinical tasks.

Abstract source

This 2014 study presents a two-stage method for segmenting lungs in CT scans that contain a broad range of abnormalities. The authors evaluated the approach on more than 400 scans and reported limitations including sensitivity to excessive noise and external objects.

Summary

The study addresses the difficulty of segmenting lungs in computed tomography (CT) scans when abnormalities differ in appearance from normal lung tissue. Its proposed two-stage framework begins with fuzzy connectedness, an image-segmentation method, to extract lung parenchyma. It then uses rib-cage-based volume estimates to identify scans for refinement, applying texture features and neighboring-anatomy information to include abnormal regions that the initial stage may miss.

The authors evaluated the method on more than 400 CT scans containing a range of abnormalities, using expert manual segmentations and an external lung-segmentation challenge. They reported overlap scores above 95% in their evaluation. The paper also notes limitations: excessive image noise, external objects such as tubes or implants, and some rare cases may affect performance. This study reports retrospective algorithm evaluation; it does not establish prospective clinical validation or readiness for clinical use.

Cite this work

Awais Mansoor; Ulas Bagci; Ziyue Xu; Brent Foster; Kenneth N. Olivier; Jason M. Elinoff; Anthony F. Suffredini; Jayaram K. Udupa; Daniel J. Mollura (2014). A generic approach to pathological lung segmentation. IEEE Transactions on Medical Imaging, 33(12), 2293–2310 https://doi.org/10.1109/TMI.2014.2337057

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