This study investigates the effectiveness of U-Net architectures integrated with various convolutional neural network (CNN) backbones for automated lung cancer detection and segmentation in chest CT images, addressing the critical need for accurate diagnostic tools in clinical settings. A balanced dataset of 832 chest CT images (416 cancerous and 416 non-cancerous) was preprocessed using Contrast Limited Adaptive Histogram Equalization (CLAHE) and resized to 128x128 pixels. U-Net models were developed with three CNN backbones: ResNet50, VGG16, and Xception, to segment lung regions. After segmentation, CNN-based classifiers and hybrid models combining CNN feature extraction with traditional machine learning classifiers (Support Vector Machine, Random Forest, and Gradient Boosting) were evaluated using 5-fold cross-validation. Metrics included accuracy, precision, recall, F1-score, Dice coefficient, and ROC-AUC. U-Net with ResNet50 achieved the best performance for cancerous lungs (Dice: 0.9495, Accuracy: 0.9735), while U-Net with VGG16 performed best for non-cancerous segmentation (Dice: 0.9532, Accuracy: 0.9513). For classification, the CNN model using U-Net with Xception achieved 99.1 percent accuracy, 99.74 percent recall, and 99.42 percent F1-score. The hybrid CNN-SVM-Xception model achieved 96.7 percent accuracy and 97.88 percent F1-score. Compared to prior methods, our framework consistently outperformed existing models. In conclusion, combining U-Net with advanced CNN backbones provides a powerful method for both segmentation and classification of lung cancer in CT scans, supporting early diagnosis and clinical decision-making.

Fetal lung maturity is a critical indicator for predicting neonatal outcomes and the need for post-natal intervention, especially for pregnancies affected by fetal growth restriction. Intra-voxel incoherent motion analysis has shown promising results for non-invasive assessment of fetal lung development, but its reliance on manual segmentation is time-consuming, thus limiting its clinical applicability. In this work, we present an automated lung maturity evaluation pipeline for diffusion-weighted magnetic resonance images that consists of a deep learning-based fetal lung segmentation model and a model-fitting lung maturity assessment. A 3D nnU-Net model was trained on manually segmented images selected from the baseline frames of 4D diffusion-weighted MRI scans. The segmentation model demonstrated robust performance, yielding a mean Dice coefficient of 82.14 %. Next, voxel-wise model fitting was performed based on both the nnU-Net-predicted and manual lung segmentations to quantify IVIM parameters reflecting tissue microstructure and perfusion. The results suggested no differences between the two. Our work shows that a fully automated pipeline is possible for supporting fetal lung maturity assessment and clinical decision-making.

Lung magnetic resonance imaging (MRI) with ultrashort echo-time (UTE) represents a recent breakthrough in lung structure imaging, providing image resolution and quality comparable to computed tomography (CT). Due to the absence of ionising radiation, MRI is often preferred over CT in paediatric diseases such as cystic fibrosis (CF), one of the most common genetic disorders in Caucasians. To assess structural lung damage in CF imaging, CT scoring systems provide valuable quantitative insights for disease diagnosis and progression. However, few quantitative scoring systems are available in structural lung MRI (e.g., UTE-MRI). To provide fast and accurate quantification in lung MRI, we investigated the feasibility of novel Artificial intelligence-assisted Pixel-level Lung (APL) scoring for CF. APL scoring consists of 5 stages, including 1) image loading, 2) AI lung segmentation, 3) lung-bounded slice sampling, 4) pixel-level annotation, and 5) quantification and reporting. The results shows that our APL scoring took 8.2 minutes per subject, which was more than twice as fast as the previous grid-level scoring. Additionally, our pixel-level scoring was statistically more accurate (p=0.021), while strongly correlating with grid-level scoring (R=0.973, p=5.85e-9). This tool has great potential to streamline the workflow of UTE lung MRI in clinical settings, and be extended to other structural lung MRI sequences (e.g., BLADE MRI), and for other lung diseases (e.g., bronchopulmonary dysplasia).

Segmenting anatomical structures in medical images plays an important role in the quantitative assessment of various diseases. However, accurate segmentation becomes significantly more challenging in the presence of disease. Disease patterns can alter the appearance of surrounding healthy tissues, introduce ambiguous boundaries, or even obscure critical anatomical structures. As such, segmentation models trained on real-world datasets may struggle to provide good anatomical segmentation, leading to potential misdiagnosis. In this paper, we generate counterfactual (CF) images to simulate how the same anatomy would appear in the absence of disease without altering the underlying structure. We then use these CF images to segment structures of interest, without requiring any changes to the underlying segmentation model. Our experiments on two real-world clinical chest X-ray datasets show that the use of counterfactual images improves anatomical segmentation, thereby aiding downstream clinical decision-making.

Chest radiography is climacteric in identifying different pulmonary diseases, yet radiologist workload and inefficiency can lead to misdiagnoses. Automatic, accurate, and efficient segmentation of lung from X-ray images of chest is paramount for early disease detection. This study develops a deep learning framework using a Pix2pix Generative Adversarial Network (GAN) to segment pulmonary abnormalities from CXR images. This framework's image preprocessing and augmentation techniques were properly incorporated with a U-Net-inspired generator-discriminator architecture. Initially, it loaded the CXR images and manual masks from the Montgomery and Shenzhen datasets, after which preprocessing and resizing were performed. A U-Net generator is applied to the processed CXR images that yield segmented masks; then, a Discriminator Network differentiates between the generated and real masks. Montgomery dataset served as the model's training set in the study, and the Shenzhen dataset was used to test its robustness, which was used here for the first time. An adversarial loss and an L1 distance were used to optimize the model in training. All metrics, which assess precision, recall, F1 score, and Dice coefficient, prove the effectiveness of this framework in pulmonary abnormality segmentation. It, therefore, sets the basis for future studies to be performed shortly using diverse datasets that could further confirm its clinical applicability in medical imaging.

In clinical procedures, precise localization of the target area is an essential step for clinical diagnosis and screening. For many diagnostic applications, lung segmentation of chest X-ray images is an essential first step that significantly reduces the image size to speed up the subsequent analysis. One of the primary difficulties with this task is segmenting the lung regions covered by dense abnormalities also known as opacities due to diseases like pneumonia and tuberculosis. SAM has astonishing generalization capabilities for category agnostic segmentation. In this study we propose an algorithm to improve zero shot performance of SAM on lung region segmentation task by automatic prompt selection. Two separate UNet models were trained, one for predicting lung segments and another for heart segment. Though these predictions lack fine details around the edges, they provide positive and negative points as prompt for SAM. Using proposed prompting method zero shot performance of SAM is evaluated on two benchmark datasets. ViT-l version of the model achieved slightly better performance compared to other two versions, ViTh and ViTb. It yields an average Dice score of 95.5 percent and 94.9 percent on hold out data for two datasets respectively. Though, for most of the images, SAM did outstanding segmentation, its prediction was way off for some of the images. After careful inspection it is found that all of these images either had extreme abnormality or distorted shape. Unlike most of the research performed so far on lung segmentation from CXR images using SAM, this study proposes a fully automated prompt selection process only from the input image. Our finding indicates that using pretrained models for prompt selection can utilize SAM impressive generalization capability to its full extent.

This paper addresses the problem of pathological lung segmentation, a significant challenge in medical image analysis, particularly pronounced in cases of peripheral opacities (severe fibrosis and consolidation) because of the textural similarity between lung tissue and surrounding areas. To overcome these challenges, this paper emphasizes the use of CycleGAN for unpaired image-to-image translation, in order to provide an augmentation method able to generate fake pathological images matching an existing ground truth. Although previous studies have employed CycleGAN, they often neglect the challenge of shape deformation, which is crucial for accurate medical image segmentation. Our work introduces an innovative strategy that incorporates additional loss functions. Specifically, it proposes an L1 loss based on the lung surrounding which shape is constrained to remain unchanged at the transition from the healthy to pathological domains. The lung surrounding is derived based on ground truth lung masks available in the healthy domain. Furthermore, preprocessing steps, such as cropping based on ribs/vertebra locations, are applied to refine the input for the CycleGAN, ensuring that the network focus on the lung region. This is essential to avoid extraneous biases, such as the zoom effect bias, which can divert attention from the main task. The method is applied to enhance in semi-supervised manner the lung segmentation process by employing a U-Net model trained with on-the-fly data augmentation incorporating synthetic pathological tissues generated by the CycleGAN model. Preliminary results from this research demonstrate significant qualitative and quantitative improvements, setting a new benchmark in the field of pathological lung segmentation. Our code is available at https://github.com/noureddinekhiati/Semi-supervised-lung-segmentation

Lung segmentation in chest X-ray images is of paramount importance as it plays a crucial role in the diagnosis and treatment of various lung diseases. This paper presents a novel approach for lung segmentation in chest X-ray images by integrating U-net with attention mechanisms. The proposed method enhances the U-net architecture by incorporating a Convolutional Block Attention Module (CBAM), which unifies three distinct attention mechanisms: channel attention, spatial attention, and pixel attention. The channel attention mechanism enables the model to concentrate on the most informative features across various channels. The spatial attention mechanism enhances the model's precision in localization by focusing on significant spatial locations. Lastly, the pixel attention mechanism empowers the model to focus on individual pixels, further refining the model's focus and thereby improving the accuracy of segmentation. The adoption of the proposed CBAM in conjunction with the U-net architecture marks a significant advancement in the field of medical imaging, with potential implications for improving diagnostic precision and patient outcomes. The efficacy of this method is validated against contemporary state-of-the-art techniques, showcasing its superiority in segmentation performance.

In the field of medical imaging, accurate segmentation of lungs on X-rays is important in many applications [6], from early disease detection to treatment planning and patient monitoring. As healthcare evolves, the need for fast and accurate tools grows, implying physician support with deep learning approaches [5]. In particular, solutions such as U-Net demonstrate the potential to automate the task of lung segmentation, offering promising advances in improved accuracy [8]. However, despite these advances, the inevitable diversity of X-ray images makes it difficult for some modern segmentation methods to deal with them. Although many solutions show high performance in simple and typical cases, their performance degrades when confronted with complex ones. Moreover, the issue of using pre-trained models on images with different characteristics may have potential negative consequences when used for real-world solutions [3]. Recognizing these challenges, our objective is to analyze existing solutions for lung segmentation and systematically evaluate their performance across a dataset of varying characteristics. In this study, we analyze and compare three prominent methods - Lung VAE, TransResUNet, and CE-Net - using five image modifications. The ultimate goal is to determine the most accurate method for lung segmentation in diverse scenarios.

Recently there has been an explosion in the use of Deep Learning (DL) methods for medical image segmentation. However the field's reliability is hindered by the lack of a common base of reference for accuracy/performance evaluation and the fact that previous research uses different datasets for evaluation. In this paper, an extensive comparison of DL models for lung and COVID-19 lesion segmentation in Computerized Tomography (CT) scans is presented, which can also be used as a benchmark for testing medical image segmentation models. Four DL architectures (Unet, Linknet, FPN, PSPNet) are combined with 25 randomly initialized and pretrained encoders (variations of VGG, DenseNet, ResNet, ResNext, DPN, MobileNet, Xception, Inception-v4, EfficientNet), to construct 200 tested models. Three experimental setups are conducted for lung segmentation, lesion segmentation and lesion segmentation using the original lung masks. A public COVID-19 dataset with 100 CT scan images (80 for train, 20 for validation) is used for training/validation and a different public dataset consisting of 829 images from 9 CT scan volumes for testing. Multiple findings are provided including the best architecture-encoder models for each experiment as well as mean Dice results for each experiment, architecture and encoder independently. Finally, the upper bounds improvements when using lung masks as a preprocessing step or when using pretrained models are quantified. The source code and 600 pretrained models for the three experiments are provided, suitable for fine-tuning in experimental setups without GPU capabilities.