# Adversarial Transformer for Repairing Human Airway Segmentation

arXiv: https://arxiv.org/abs/2210.12029 · HTML: https://mlsanity.com/paper/2210.12029/

## Key facts

- Cited by 4 papers in the map (data through 14 Oct 2026).
- Builds on 15 of its 33 references that are in the map.
- First posted on arXiv 21 Oct 2022.

## Builds on (most cited first, 15 of 15)

- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Image-to-Image Translation with Conditional Adversarial Networks](https://mlsanity.com/paper/1611.07004/) (2016)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [Deeply-Supervised Nets](https://mlsanity.com/paper/1409.5185/) (2014)
- [clDice -- A Novel Topology-Preserving Loss Function for Tubular Structure Segmentation](https://mlsanity.com/paper/2003.07311/) (2020)
- [TransBTS: Multimodal Brain Tumor Segmentation Using Transformer](https://mlsanity.com/paper/2103.04430/) (2021)
- [Medical Image Segmentation Using Squeeze-and-Expansion Transformers](https://mlsanity.com/paper/2105.09511/) (2021)
- [Alleviating Class-wise Gradient Imbalance for Pulmonary Airway Segmentation](https://mlsanity.com/paper/2011.11952/) (2020)
- [Automatic Airway Segmentation in chest CT using Convolutional Neural Networks](https://mlsanity.com/paper/1808.04576/) (2018)
- [Fuzzy Attention Neural Network to Tackle Discontinuity in Airway Segmentation](https://mlsanity.com/paper/2209.02048/) (2022)
- [NaviAirway: a Bronchiole-sensitive Deep Learning-based Airway Segmentation Pipeline](https://mlsanity.com/paper/2203.04294/) (2022)

## Built on by (most cited first, 4 of 4)

- [AeroPath: An airway segmentation benchmark dataset with challenging pathology](https://mlsanity.com/paper/2311.01138/) (2023)
- [Intensity Confusion Matters: An Intensity-Distance Guided Loss for Bronchus Segmentation](https://mlsanity.com/paper/2406.16150/) (2024)
- [Fuzzy Attention-based Border Rendering Network for Lung Organ Segmentation](https://mlsanity.com/paper/2406.16189/) (2024)
- [RepAir: A Framework for Airway Segmentation and Discontinuity Correction in CT](https://mlsanity.com/paper/2511.14649/) (2025)

## Abstract (arXiv)

Discontinuity in the delineation of peripheral bronchioles hinders the potential clinical application of automated airway segmentation models. Moreover, the deployment of such models is limited by the data heterogeneity across different centres, and pathological abnormalities also make achieving accurate robust segmentation in distal small airways difficult. Meanwhile, the diagnosis and prognosis of lung diseases often rely on evaluating structural changes in those anatomical regions. To address this gap, this paper presents a patch-scale adversarial-based refinement network that takes in preliminary segmentation along with original CT images and outputs a refined mask of the airway structure. The method is validated on three different datasets encompassing healthy cases, cases with cystic fibrosis and cases with COVID-19. The results are quantitatively evaluated by seven metrics and achieved more than a 15% rise in detected length ratio and detected branch ratio, showing promising performance compared to previously proposed models. The visual illustration also proves our refinement guided by a patch-scale discriminator and centreline objective functions is effective in detecting discontinuities and missing bronchioles. Furthermore, the generalizability of our refinement pipeline is tested on three previous models and improves their segmentation completeness significantly.