Refining the Classroom: The Self-Supervised Professor Model for Improved Segmentation of Locally Advanced Pancreatic Ductal Adenocarcinoma

Journal of Imaging Informatics in Medicine, vol. 39, pp. 2330–2339

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is a leading cause of cancer-related deaths, with accurate staging being critical for treatment planning. Automated 3D segmentation models can aid in staging, but segmenting PDAC, especially in cases of locally advanced pancreatic cancer (LAPC), is challenging due to the tumor's heterogeneous appearance, irregular shapes, and extensive infiltration. This study developed and evaluated a tripartite self-supervised learning architecture for improved 3D segmentation of LAPC, addressing the challenges of heterogeneous appearance, irregular shapes, and extensive infiltration in PDAC. We implemented a tripartite architecture consisting of a teacher model, a professor model, and a student model. The teacher model, trained on manually segmented CT scans, generated initial pseudo-segmentations. The professor model refined these segmentations, which were then used to train the student model. We utilized 1115 CT scans from 903 patients for training. Three expert abdominal radiologists manually segmented 30 CT scans from 27 patients with LAPC, serving as reference standards. We evaluated the performance using DICE, Hausdorff distance (HD95), and mean surface distance (MSD). The teacher, professor, and student models achieved average DICE scores of 0.60, 0.73, and 0.75, respectively, with significant boundary accuracy improvements (teacher HD95/MSD, 25.71/5.96 mm; professor, 9.68/1.96 mm; student, 4.79/1.34 mm). Our findings demonstrate that the professor model significantly enhances segmentation accuracy for LAPC (p < 0.01). Both the professor and student models offer substantial improvements over previous work. The introduced tripartite self-supervised learning architecture shows promise for improving automated 3D segmentation of LAPC, potentially aiding in more accurate staging and treatment planning.

Authors 14

1. Jacqueline Isabel Bereska corresponding

   Amsterdam University Medical Centers · Cancer Center Amsterdam · University of Amsterdam

   Affiliation as printed

   Cancer Center Amsterdam, Amsterdam, the Netherlands. j.i.bereska@amsterdamUMC.nl

   Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. j.i.bereska@amsterdamUMC.nl

   Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. j.i.bereska@amsterdamUMC.nl

   Cancer Center Amsterdam, Amsterdam, the Netherlands

   Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands

2. Selina Palic

   Amsterdam University Medical Centers · Cancer Center Amsterdam · University of Amsterdam

   Affiliation as printed

   Cancer Center Amsterdam, Amsterdam, the Netherlands

   Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands

   Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands

3. Leonard F. Bereska

   University of Amsterdam

   Affiliation as printed

   Video and Image Sense Lab, University of Amsterdam, Amsterdam, the Netherlands

4. Efstratios Gavves

   University of Amsterdam

   Affiliation as printed

   Video and Image Sense Lab, University of Amsterdam, Amsterdam, the Netherlands

5. C. Yung Nio

   Amsterdam University Medical Centers · University of Amsterdam

   Affiliation as printed

   Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands

6. Marnix P. M. Kop

   Amsterdam University Medical Centers · University of Amsterdam

   Affiliation as printed

   Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands

7. Femke Struik

   Amsterdam University Medical Centers · University of Amsterdam

   Affiliation as printed

   Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands

8. Freek D. Daams

   Amsterdam University Medical Centers · Cancer Center Amsterdam · Vrije Universiteit Amsterdam

   Affiliation as printed

   Cancer Center Amsterdam, Amsterdam, the Netherlands

   Department of Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

9. Martijn A. van Dam Aachen Department of Surgery, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands

10. Tom H. Dijkhuis Aachen Department of Surgery, Leiden University Medical Center

    Leiden University Medical Center

    Affiliation as printed

    Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands

11. Marc G. Besselink

    Amsterdam University Medical Centers · Cancer Center Amsterdam · Vrije Universiteit Amsterdam

    Affiliation as printed

    Cancer Center Amsterdam, Amsterdam, the Netherlands

    Department of Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

12. Henk A. Marquering

    Amsterdam University Medical Centers · Cancer Center Amsterdam · University of Amsterdam

    Affiliation as printed

    Cancer Center Amsterdam, Amsterdam, the Netherlands

    Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands

    Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands

13. Jaap Stoker

    Amsterdam University Medical Centers · Cancer Center Amsterdam · Amsterdam Gastroenterology Endocrinology Metabolism · University of Amsterdam

    Affiliation as printed

    Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, the Netherlands

    Cancer Center Amsterdam, Amsterdam, the Netherlands

    Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands

14. Inez M. Verpalen corresponding

    Amsterdam University Medical Centers · Cancer Center Amsterdam · University of Amsterdam

    Affiliation as printed

    Cancer Center Amsterdam, Amsterdam, the Netherlands. i.m.verpalen@amsterdamUMC.nl

    Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. i.m.verpalen@amsterdamUMC.nl

    Cancer Center Amsterdam, Amsterdam, the Netherlands

    Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands