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Feature-enhanced Adversarial Semi-supervised Semantic Segmentation Network for Pulmonary Embolism Annotation

This study established a feature-enhanced adversarial semi-supervised semantic segmentation model to automatically annotate pulmonary embolism lesion areas in computed tomography pulmonary angiogram (CTPA) images. In current studies, all of the PE CTPA image segmentation methods are trained by supervised learning. However, the supervised learning models need to be retrained and the images need to be relabeled when the CTPA images come from different hospitals. This study proposed a semi-supervised learning method to make the model applicable to different datasets by adding a small amount of unlabeled images. By training the model with both labeled and unlabeled images, the accuracy of unlabeled images can be improved and the labeling cost can be reduced. Our semi-supervised segmentation model includes a segmentation network and a discriminator network. We added feature information generated from the encoder of segmentation network to the discriminator so that it can learn the similarity between predicted mask and ground truth mask. This HRNet-based architecture can maintain a higher resolution for convolutional operations so the prediction of small PE lesion areas can be improved. We used the labeled open-source dataset and the unlabeled National Cheng Kung University Hospital (NCKUH) (IRB number: B-ER-108-380) dataset to train the semi-supervised learning model, and the resulting mean intersection over union (mIOU), dice score, and sensitivity achieved 0.3510, 0.4854, and 0.4253, respectively on the NCKUH dataset. Then, we fine-tuned and tested the model with a small amount of unlabeled PE CTPA images from China Medical University Hospital (CMUH) (IRB number: CMUH110-REC3-173) dataset. Comparing the results of our semi-supervised model with the supervised model, the mIOU, dice score, and sensitivity improved from 0.2344, 0.3325, and 0.3151 to 0.3721, 0.5113, and 0.4967, respectively.