Accurate segmentation of multiple organs of the head, neck, chest, and abdomen from medical images is an essential step in computer-aided diagnosis, surgical navigation, and radiation therapy. In the past few years, with a data-driven feature extraction approach and end-to-end training, automatic deep learning-based multi-organ segmentation method has far outperformed traditional methods and become a new research topic. This review systematically summarizes the latest research in this field. For the first time, from the perspective of full and imperfect annotation, we comprehensively compile 161 studies on deep learning-based multi-organ segmentation in multiple regions such as the head and neck, chest, and abdomen, containing a total of 214 related references. The method based on full annotation summarizes the existing methods from four aspects: network architecture, network dimension, network dedicated modules, and network loss function. The method based on imperfect annotation summarizes the existing methods from two aspects: weak annotation-based methods and semi annotation-based methods. We also summarize frequently used datasets for multi-organ segmentation and discuss new challenges and new research trends in this field.
Accurate identification and localization of the vertebrae in CT scans is a critical and standard preprocessing step for clinical spinal diagnosis and treatment. Existing methods are mainly based on the integration of multiple neural networks, and most of them use the Gaussian heat map to locate the vertebrae's centroid. However, the process of obtaining the vertebrae's centroid coordinates using heat maps is non-differentiable, so it is impossible to train the network to label the vertebrae directly. Therefore, for end-to-end differential training of vertebra coordinates on CT scans, a robust and accurate automatic vertebral labeling algorithm is proposed in this study. Firstly, a novel residual-based multi-label classification and localization network is developed, which can capture multi-scale features, but also utilize the residual module and skip connection to fuse the multi-level features. Secondly, to solve the problem that the process of finding coordinates is non-differentiable and the spatial structure is not destructible, integral regression module is used in the localization network. It combines the advantages of heat map representation and direct regression coordinates to achieve end-to-end training, and can be compatible with any key point detection methods of medical image based on heat map. Finally, multi-label classification of vertebrae is carried out, which use bidirectional long short term memory (Bi-LSTM) to enhance the learning of long contextual information to improve the classification performance. The proposed method is evaluated on a challenging dataset and the results are significantly better than the state-of-the-art methods (mean localization error <3mm).