This paper presents a comparison study between 10 automatic and six interactive methods for liver segmentation from contrast-enhanced CT images. It is based on results from the "MICCAI 2007 Grand Challenge" workshop, where 16 teams evaluated their algorithms on a common database. A collection of 20 clinical images with reference segmentations was provided to train and tune algorithms in advance. Participants were also allowed to use additional proprietary training data for that purpose. All teams then had to apply their methods to 10 test datasets and submit the obtained results. Employed algorithms include statistical shape models, atlas registration, level-sets, graph-cuts and rule-based systems. All results were compared to reference segmentations five error measures that highlight different aspects of segmentation accuracy. All measures were combined according to a specific scoring system relating the obtained values to human expert variability. In general, interactive methods reached higher average scores than automatic approaches and featured a better consistency of segmentation quality. However, the best automatic methods (mainly based on statistical shape models with some additional free deformation) could compete well on the majority of test images. The study provides an insight in performance of different segmentation approaches under real-world conditions and highlights achievements and limitations of current image analysis techniques.

Endobronchial-valve treatment significantly improved pulmonary function and exercise capacity in patients with severe emphysema characterized by an absence of interlobar collateral ventilation. (Funded by the Netherlands Organization for Health Research and Development and the University Medical Center Groningen; Netherlands Trial Register number, NTR2876.).

Abstract. This paper describes a framework for evaluating airway extraction algorithms in a standardized manner and establishing reference segmentations that can be used for future algorithm development. Because of the sheer difficulty of constructing a complete reference standard manually, we propose to construct a reference using results from the algorithms being compared, by splitting each airway tree segmentation result into individual branch segments that are subsequently visually inspected by trained observers. Using the so constructed reference, a total of seven performance measures covering different aspects of segmentation quality are computed. We evaluated 15 airway tree extraction algorithms from different research groups on a diverse set of 20 chest CT scans from subjects ranging from healthy volunteers to patients with severe lung disease, who were scanned at different sites, with several different CT scanner models, and using a variety of scanning protocols and reconstruction parameters.

CORADS-AI is a freely accessible deep learning algorithm that automatically assigns CO-RADS and CT severity scores to non-contrast CT scans of patients suspected of COVID-19 with high diagnostic performance.

Lung segmentation is a prerequisite for automated analysis of chest CT scans. Conventional lung segmentation methods rely on large attenuation differences between lung parenchyma and surrounding tissue. These methods fail in scans where dense abnormalities are present, which often occurs in clinical data. Some methods to handle these situations have been proposed, but they are too time consuming or too specialized to be used in clinical practice. In this article, a new hybrid lung segmentation method is presented that automatically detects failures of a conventional algorithm and, when needed, resorts to a more complex algorithm, which is expected to produce better results in abnormal cases. In a large quantitative evaluation on a database of 150 scans from different sources, the hybrid method is shown to perform substantially better than a conventional approach at a relatively low increase in computational cost.

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BackgroundThe lung volume reduction (LVR) coil is a minimally invasive bronchoscopic nitinol device designed to reduce hyperinflation and improve elastic recoil in severe emphysema. We investigated the feasibility, safety and efficacy of LVR coil treatment in a prospective multicentre cohort trial in patients with severe emphysema.MethodsPatients were treated in 11 centres. Safety was evaluated by recording all adverse events, efficacy by the St George's Respiratory Questionnaire (SGRQ) as primary endpoint, and pulmonary function testing, modified Medical Research Council dyspnoea score (mMRC) and 6-min walk distance (6MWD) up to 12 months after the final treatment.ResultsSixty patients (60.9 ± 7.5 years, forced expiratory volume in 1 s (FEV1) 30.2 ± 6.3% pred) were bronchoscopically treated with coils (55 bilateral, 5 unilateral), with a median of 10 (range 5–15) coils per lobe. Within 30 days post-treatment, seven chronic obstructive pulmonary disease exacerbations (6.1%), six pneumonias (5.2%), four pneumothoraces (3.5%) and one haemoptysis (0.9%) occurred as serious adverse events. At 6 and 12 months, respectively, ΔSGRQ was −12.1±12.9 and −11.1±13.3 points, Δ6MWD was +29.7±74.1 m and +51.4±76 m, ΔFEV1 was +0.11±0.20 L and +0.11±0.30 L, and ΔRV (residual volume) was −0.65±0.90 L and −0.71±0.81 L (all p<0.01). Post hoc analyses showed significant responses for SGRQ, 6MWD and RV in patients with both heterogeneous and homogeneous emphysema.ConclusionsLVR coil treatment results in significant clinical improvements in patients with severe emphysema, with a good safety profile and sustained results for up to 1 year.Trial registration number:NCT01328899.