构建可扩展的心脏CT分割与表型分析框架,实现高效精准的自动标注。
A Unified Framework for Comprehensive Cardiac CT Segmentation and Phenotyping: Human-in-the-Loop Data Annotation, Vision Foundation Model Development, Multicenter Evaluation and Clinical Validation
- 引入人机协同标注与自监督预训练,提升数据标注效率。
- 在5个外部数据集上实现14种心脏结构的更准确分割,低数据量下效果尤佳。
- 开源超大规模标注数据集与工具链,适合医学影像研究者使用。
从计算机断层扫描(CT)中全面量化心脏结构的挑战不在于数据数量,而在于测量的可扩展性,导致临床常规应用困难。本文提出一个统一框架,整合人机协同标注流程、心脏CT增强技术及基于6万张未标注心脏CT扫描自监督预训练的基础模型。通过该方法,构建了迄今最大最全面的人工标注心脏CT分割数据集,包含1598例病例和14种心脏结构(训练集1000例,外部测试集598例)。在五个外部数据集上,该框架对所有结构的分割精度和完整性均优于现有开源工具。自监督预训练显著提升了标注效率,尤其在低数据场景下表现突出。对比卷积、变换器与状态空间架构,性能相当,表明数据质量和预训练比模型结构更影响准确性。框架已扩展至人群水平表型分析,分割结果包含超越人口统计学变量的功能信息,如心室功能与疾病严重程度。本文公开发布最大规模人工标注数据集、代码、模型权重、CT增强库与软件,为常规获取的CT扫描中开展机会性心脏表型分析提供可复现基础。
原文摘要 · Abstract (English)
Comprehensive quantification of cardiac structures from computed tomography (CT) remains limited not by data availability but by the scalability of measurements, which makes routine use impractical. Here we present a unified framework for comprehensive cardiac CT segmentation and phenotyping that combines a human-in-the-loop annotation pipeline, a cardiac CT augmentation technique, and a self-supervised foundation model pre-trained on 60,000 unlabeled cardiac CT scans. Using this approach, we assembled the largest and most comprehensive expert-annotated cardiac CT segmentation dataset to date, comprising 1598 cases and 14 distinct cardiac structures (1000 for training, 598 for the external test set). Across five external datasets, the framework segmented all structures more accurately and comprehensively than existing open-source tools. Self-supervised pre-training improved labeling efficiency, with the most significant gains observed during external evaluation in the low-data regime. Benchmarking across convolutional, transformer, and state-space architectures showed comparable performance, indicating that data quality and pre-training, rather than architecture, drove accuracy. The framework was scaled to population-level phenotyping, with segmented anatomy that carries functionally relevant information about ventricular function and disease severity beyond demographic variables. By openly releasing the largest dataset with human labels, code, model weights, a CT augmentation library, and software, this work provides a reproducible foundation for opportunistic cardiac phenotyping from routinely acquired CT scans.
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