CTG-Net: An Efficient Cascaded Framework Driven by Terminal Guidance Mechanism for Dilated Pancreatic Duct Segmentation

Pancreatic duct dilation indicates a high risk of various pancreatic diseases. Segmentation of dilated pancreatic ducts on computed tomography (CT) images shows the potential to assist the early diagnosis, surgical planning and prognosis. Because of the ducts' tiny sizes, slender tubular structures and the surrounding distractions, most current researches on pancreatic duct segmentation achieve low accuracy and always have segmentation errors on the terminal parts of the ducts. To address these problems, we propose a terminal guidance mechanism called cascaded terminal guidance network (CTG-Net). Firstly, a terminal attention mechanism is established on the skeletons extracted from the coarse predictions. Then, to get fine terminal segmentation, a subnetwork is designed for jointly learning the local intensity from the original images, feature cues from coarse predictions and global anatomy information from the pancreas distance transform maps. Finally, a terminal distraction attention module which explicitly learns the distribution of the terminal distraction is proposed to reduce the false positive and false negative predictions. We also propose a new metric called tDice to measure the terminal segmentation accuracy for targets with tubular structures and two segmentation metrics for distractions. We collect our dilated pancreatic duct segmentation dataset with 150 CT scans from patients with 5 types of pancreatic tumors. Experimental results on our dataset show that our proposed approach boosts dilated pancreatic duct segmentation accuracy by nearly 20% compared with the existing results, and achieves more than 9% improvement for the terminal segmentation accuracy compared with the state-of-the-art methods.