Automated lung tumor segmentation robust to various tumor sizes using a consistency learning-based multi-scale dual-attention network.

Background: It is often difficult to automatically segment lung tumors due to the large tumor size variation ranging from less than 1 cm to greater than 7 cm depending on the T-stage.

Objective: This study aims to accurately segment lung tumors of various sizes using a consistency learning-based multi-scale dual-attention network (CL-MSDA-Net).

Methods: To avoid under- and over-segmentation caused by different ratios of lung tumors and surrounding structures in the input patch according to the size of the lung tumor, a size-invariant patch is generated by normalizing the ratio to the average size of the lung tumors used for the training. Two input patches, a size-invariant patch and size-variant patch are trained on a consistency learning-based network consisting of dual branches that share weights to generate a similar output for each branch with consistency loss. The network of each branch has a multi-scale dual-attention module that learns image features of different scales and uses channel and spatial attention to enhance the scale-attention ability to segment lung tumors of different sizes.

Results: In experiments with hospital datasets, CL-MSDA-Net showed an F1-score of 80.49%, recall of 79.06%, and precision of 86.78%. This resulted in 3.91%, 3.38%, and 2.95% higher F1-scores than the results of U-Net, U-Net with a multi-scale module, and U-Net with a multi-scale dual-attention module, respectively. In experiments with the NSCLC-Radiomics datasets, CL-MSDA-Net showed an F1-score of 71.7%, recall of 68.24%, and precision of 79.33%. This resulted in 3.66%, 3.38%, and 3.13% higher F1-scores than the results of U-Net, U-Net with a multi-scale module, and U-Net with a multi-scale dual-attention module, respectively.

Conclusions: CL-MSDA-Net improves the segmentation performance on average for tumors of all sizes with significant improvements especially for small sized tumors.