Self-supervised region-aware segmentation of COVID-19 CT images using 3D GAN and contrastive learning

Medical image segmentation is a key initial step in several therapeutic applications. While most of the automatic segmentation models are supervised, which require a well-annotated paired dataset, we introduce a novel annotation-free pipeline to perform segmentation of COVID-19 CT images. Our pipeline consists of three main subtasks: automatically generating a 3D pseudo-mask in self-supervised mode using a generative adversarial network (GAN), leveraging the quality of the pseudo-mask, and building a multi-objective segmentation model to predict lesions. Our proposed 3D GAN architecture removes infected regions from COVID-19 images and gen-erates synthesized healthy images while keeping the 3D structure of the lung the same. Then, a 3D pseudo-mask is generated by subtracting the synthesized healthy images from the original COVID-19 CT images. We enhanced pseudo-masks using a contrastive learning approach to build a region-aware segmentation model to focus more on the infected area. The final segmentation model can be used to predict lesions in COVID-19 CT images without any manual annotation at the pixel level. We show that our approach outperforms the existing state-of-the-art unsupervised and weakly-supervised segmentation techniques on three datasets by a reasonable margin. Spe-cifically, our method improves the segmentation results for the CT images with low infection by increasing sensitivity by 20% and the dice score up to 4%. The proposed pipeline overcomes some of the major limitations of existing unsupervised segmentation approaches and opens up a novel horizon for different applications of medical image segmentation.