用骨骼解剖结构预训练,提升前列腺癌骨转移病灶在全身MRI中的分割精度。
Learning from Anatomy: Supervised Anatomical Pretraining (SAP) for Improved Metastatic Bone Disease Segmentation in Whole-Body MRI
- 基于健康人MRI训练骨骼分割模型,提供解剖先验知识
- 在44名患者上实现0.76的表面Dice和0.64的病灶Dice
- 对大于1ml的临床关键病灶检测灵敏度达100%(28/32例)
全身MRI中转移性骨病(MBD)的分割极具挑战,因病灶形态多变、位置不一、边界模糊及类别严重不平衡,需大量标注数据。但高质量标注耗时耗力且易出错。自监督学习虽可利用大规模未标注数据,但学到的通用表征难以捕捉病灶检测所需的细微特征。本文提出受监督解剖预训练(SAP)方法,利用有限解剖标签数据进行训练:首先在健康人全身MRI上训练骨骼分割模型以实现高质量骨骼勾画;随后在44名前列腺癌转移患者中评估其在下游病灶分割任务中的表现,对比随机初始化基线与先进自监督学习方法。SAP显著优于两者,达到0.76的归一化表面Dice和0.64的Dice系数,病灶检测F2分数达0.44,高于基线(0.24)与自监督(0.31)。当仅关注大于1ml的临床相关病灶时,SAP在32例患者中实现28例100%检测灵敏度。从解剖结构学习骨形态,为骨病变分割提供了有效且领域相关的归纳偏置。所有代码与模型均已公开。
原文摘要 · Abstract (English)
The segmentation of metastatic bone disease (MBD) in whole-body MRI (WB-MRI) is a challenging problem. Due to varying appearances and anatomical locations of lesions, ambiguous boundaries, and severe class imbalance, obtaining reliable segmentations requires large, well-annotated datasets capturing lesion variability. Generating such datasets requires substantial time and expertise, and is prone to error. While self-supervised learning (SSL) can leverage large unlabeled datasets, learned generic representations often fail to capture the nuanced features needed for accurate lesion detection. In this work, we propose a Supervised Anatomical Pretraining (SAP) method that learns from a limited dataset of anatomical labels. First, an MRI-based skeletal segmentation model is developed and trained on WB-MRI scans from healthy individuals for high-quality skeletal delineation. Then, we compare its downstream efficacy in segmenting MBD on a cohort of 44 patients with metastatic prostate cancer, against both a baseline random initialization and a state-of-the-art SSL method. SAP significantly outperforms both the baseline and SSL-pretrained models, achieving a normalized surface Dice of 0.76 and a Dice coefficient of 0.64. The method achieved a lesion detection F2 score of 0.44, improving on 0.24 (baseline) and 0.31 (SSL). When considering only clinically relevant lesions larger than 1~ml, SAP achieves a detection sensitivity of 100% in 28 out of 32 patients. Learning bone morphology from anatomy yields an effective and domain-relevant inductive bias that can be leveraged for the downstream segmentation task of bone lesions. All code and models are made publicly available.
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