CIA-net: Cross-modality interaction and aggregation network for ovarian tumor segmentation from multi-modal MRI

Magnetic resonance imaging (MRI) is an essential examination for ovarian cancer, in which ovarian tumor segmentation is crucial for personalized diagnosis and treatment planning. However, ovarian tumors often present with mixed cystic and solid regions in imaging, posing additional difficulties for automatic segmentation. In clinical practice, radiologists use T2-weighted imaging as the main modality to delineate tumor boundaries. In comparison, multi-modal MRI provides complementary information across modalities that can improve tumor segmentation. Therefore, it is important to fuse salient features from other modalities to the main modality. In this paper, we propose a cross-modality interaction and aggregation network (CIA-Net), a hybrid convolutional and Transformer architecture, for automatic ovarian tumor segmentation from multi-modal MRI. CIA-Net divides multi-modal MRI into one main (T2) and three minor modalities (T1, ADC, DWI), each with independent encoders. The novel cross-modality collaboration block selectively aggregates complementary features from minor modalities into the main modality through a progressive context injection module. Additionally, we introduce the progressive neighborhood integrated module to filter intra- and inter-modality noise and redundancies by refining adjacent slices of each modality. We evaluate our proposed method on a diverse, multi-center ovarian tumor dataset comprising 739 patients, and further validate its generalization and robustness on two public benchmarks for brain and cardiac segmentation. Comparative experiments with other cutting-edge techniques demonstrate the effectiveness of CIA-Net, highlighting its potential to be applied in clinical scenarios.