When delineating lesions from medical images, a human expert can always keep in mind the anatomical structure behind the voxels. However, although high-quality (though not perfect) anatomical information can be retrieved from computed tomography (CT) scans with modern deep learning algorithms, it is still an open problem how these automatically generated organ masks can assist in addressing challenging lesion segmentation tasks, such as the segmentation of colorectal cancer (CRC). In this paper, we develop a novel Anatomy-Guided segmentation framework to exploit the auto-generated organ masks to aid CRC segmentation from CT, namely AG-CRC. First, we obtain multi-organ segmentation (MOS) masks with existing MOS models (e.g., TotalSegmentor) and further derive a more robust organ of interest (OOI) mask that may cover most of the colon-rectum and CRC voxels. Then, we propose an anatomy-guided training patch sampling strategy by optimizing a heuristic gain function that considers both the proximity of important regions (e.g., the tumor or organs of interest) and sample diversity. Third, we design a novel self-supervised learning scheme inspired by the topology of tubular organs like the colon to boost the model performance further. Finally, we employ a masked loss scheme to guide the model to focus solely on the essential learning region. We extensively evaluate the proposed method on two CRC segmentation datasets, where substantial performance improvement (5% to 9% in Dice) is achieved over current state-of-the-art medical image segmentation models, and the ablation studies further evidence the efficacy of every proposed component.

利用自动生成的器官掩模辅助肠直肠癌（CRC）的CT图像分割，提出了一种新颖的解剖引导分割框架（AG-CRC），通过多器官分割、训练块采样策略、自监督学习方案和掩模损失机制，实现了5%至9%的性能改进。

AG-CRC: CT中基于解剖学指导的结肠癌分割与非理想解剖学知识