Multilevel support-assisted prototype optimization network for few-shot medical segmentation of lung lesions

Medical image annotation is scarce and costly. Few-shot segmentation has been widely used in medical image from only a few annotated examples. However, its research on lesion segmentation for lung diseases is still limited, especially for pulmonary aspergillosis. Lesion areas usually have complex shapes and blurred edges. Lesion segmentation requires more attention to deal with the diversity and uncertainty of lesions. To address this challenge, we propose MSPO-Net, a multilevel support-assisted prototype optimization network designed for few-shot lesion segmentation in computerized tomography (CT) images of lung diseases. MSPO-Net learns lesion prototypes from low-level to high-level features. Self-attention threshold learning strategy can focus on the global information and obtain an optimal threshold for CT images. Our model refines prototypes through a support-assisted prototype optimization module, adaptively enhancing their representativeness for the diversity of lesions and adapting to the unseen lesions better. In clinical examinations, CT is more practical than X-rays. To ensure the quality of our work, we have established a small-scale CT image dataset for three lung diseases and annotated by experienced doctors. Experiments demonstrate that MSPO-Net can improve segmentation performance and robustness of lung disease lesion. MSPO-Net achieves state-of-the-art performance in both single and unseen lung disease segmentation, indicating its potentiality to reduce doctors' workload and improve diagnostic accuracy. This research has certain clinical significance. Code is available at https://github.com/Tian-Yuan-ty/MSPO-Net .