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Autori principali: Atad, Matan, Marka, Alexander W., Steinhelfer, Lisa, Curto-Vilalta, Anna, Leonhardt, Yannik, Foreman, Sarah C., Dietrich, Anna-Sophia Walburga, Graf, Robert, Gersing, Alexandra S., Menze, Bjoern, Rueckert, Daniel, Kirschke, Jan S., Möller, Hendrik
Natura: Preprint
Pubblicazione: 2025
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Accesso online:https://arxiv.org/abs/2512.06849
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Sommario:
  • Accurate segmentation of vertebral metastasis in CT is clinically important yet difficult to scale, as voxel-level annotations are scarce and both lytic and blastic lesions often resemble benign degenerative changes. We introduce a 2D weakly supervised method trained solely on vertebra-level healthy/malignant labels, without any lesion masks. The method combines a Diffusion Autoencoder (DAE) that produces a classifier-guided healthy edit of each vertebra with pixel-wise difference maps that propose suspect candidate lesions. To determine which regions truly reflect malignancy, we introduce Hide-and-Seek Attribution: each candidate is revealed in turn while all others are hidden, the edited image is projected back to the data manifold by the DAE, and a latent-space classifier quantifies the isolated malignant contribution of that component. High-scoring regions form the final lytic or blastic segmentation. On held-out radiologist annotations, we achieve strong blastic/lytic performance despite no mask supervision (F1: 0.91/0.85; Dice: 0.87/0.78), exceeding baselines (F1: 0.79/0.67; Dice: 0.74/0.55). These results show that vertebra-level labels can be transformed into reliable lesion masks, demonstrating that generative editing combined with selective occlusion supports accurate weakly supervised segmentation in CT.