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In the past years sophisticated automatic segmentation algorithms for various medical image segmentation problems have been developed. However, there are always cases where automatic algorithms fail to provide an acceptable segmentation. In these cases the user needs efficient segmentation editing tools, a problem which has not received much attention in research. We give a comprehensive overview on segmentation editing for three-dimensional (3D) medical images. For segmentation editing in two-dimensional (2D) images, we discuss a sketch-based approach where the user modifies the segmentation in the contour domain. Based on this 2D interface, we present an image-based as well as an image-independent method for intuitive and efficient segmentation editing in 3D in the context of tumour segmentation in computed tomography (CT). Our editing tools have been evaluated on a database containing 1226 representative liver metastases, lung nodules and lymph nodes of different shape, size and image quality. In addition, we have performed a qualitative evaluation with radiologists and technical experts, proving the efficiency of our tools.

In oncological chemotherapy monitoring, the change of a tumor's size is an important criterion for assessing cancer therapeutics. Measuring the volume of a tumor requires its delineation in 3-D. This is called segmentation, which is an intensively studied problem in medical image processing. However, simply counting the voxels within a binary segmentation result can lead to significant differences in the volume, if the lesion has been segmented slightly differently by various segmentation procedures or in different scans, for example due to the limited spatial resolution of computed tomography (CT) or partial volume effects. This variability limits the sensitivity of size measurements and thus of therapy response assessments and it can even lead to misclassifications. We present a fast, generic algorithm for measuring the volume of solid, compact tumors in CT that considers partial volume effects at the border of a given segmentation result. The algorithm is an extension of the segmentation-based partial volume analysis proposed by Kuhnigk for the volumetry of solid lung lesions , such that it can be applied to inhomogeneous lesions and lesions with inhomogeneous surroundings. Our generalized segmentation-based partial volume correction is based on a spatial subdivision of the segmentation result, from which the fraction of tumor for each voxel is computed. It has been evaluated on phantom data, 1516 lesion segmentation pairs (lung nodules, liver metastases and lymph nodes) as well as 1851 lung nodules from the LIDC-IDRI database. The evaluations of our algorithm show a more accurate estimation of the real volume and its ability to reduce inter- and intra-observer variability significantly for each entity. Overall, the variability (interquartile range) for phantom data is reduced by 49% ( p ≪ 0.001) and the variability between different readers is reduced by 28% ( p ≪ 0.001). The average computation time is 0.2 s.

Segmentation is an essential task in medical image analysis. For example measuring tumor growth in consecutive CT scans based on the volume of the tumor requires a good segmentation. Since manual segmentation takes too much time in clinical routine automatic segmentation algorithms are typically used. However there are always cases where an automatic segmentation fails to provide an acceptable segmentation for example due to low contrast, noise or structures of the same density lying close to the lesion. These erroneous segmentation masks need to be manually corrected. We present a novel method for fast three-dimensional local manual correction of segmentation masks. The user needs to draw only one partial contour which describes the lesion's actual border. This two-dimensional interaction is then transferred into 3D using a live-wire based extrapolation of the contour that is given by the user in one slice. Seed points calculated from this contour are moved to adjacent slices by a block matching algorithm. The seed points are then connected by a live-wire algorithm which ensures a segmentation that passes along the border of the lesion. After this extrapolation a morphological postprocessing is performed to generate a coherent and smooth surface corresponding to the user drawn contour as well as to the initial segmentation. An evaluation on 108 lesions by six radiologists has shown that our method is both intuitive and fast. Using our method the radiologists were able to correct 96.3% of lesion segmentations rated as insufficient to acceptable ones in a median time of 44s

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