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Segmentation of Intracranial Hemorrhage in CT Images Based on Multi-Instance Learningand Thresholding Pseudo-Labels Extraction |
Zhang Tongyu, Li Enhui, Li Zhenyu, Cui Pengcheng, Zhang Weiwei* |
(Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005, China) |
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Abstract Intracranial hemorrhage is the bleeding caused by the rupture of intracranial blood vessels, and the volume of the hematoma is clinically important for treatment decision and prognosis analysis. The segmentation of the hematoma based on CT images is the basis of the volume measurement. Fully supervised methods rely on manually outlined labels, which are time-consuming and laborious, while existing weakly supervised segmentation methods have poor robustness and are prone to be affected by artifacts. To this end, this study proposed MIL-ICH, a multi-instance learning based weakly supervised network for intracranial hemorrhage segmentation. The network is composed of a two-branch structure. First, the multi-instance learning decoder generated heatmap to locate the hemorrhage area. Then, based on the heatmap, the pseudo-labels were extracted and optimized by CT value thresholding and pixel-adaptive refinement module to train the segmentation decoder. Finally, the two branches were trained simultaneously to improve training efficiency and leverage the multi-branch collaboration to further improve segmentation performance. The test results on 200 CT scans from the RSNA intracranial hemorrhage dataset showed that the Dice similarity coefficient and volume similarity of MIL-ICH reached 0.822 and 0.896, respectively. The correlation of the hematoma volume measured by this network with the actual hematoma volume is better than the ABC/2 estimation method commonly used in clinical practice. In conclusion, the method proposed in this work can improve the performance of weakly supervised segmentation of intracranial hemorrhage and benefit the volume measurement and prognostic evaluation for clinical purposes.
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Received: 28 April 2023
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Corresponding Authors:
*E-mail: weiwei.zhang@ibms.pumc.edu.cn
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