MESAHA-Net: Multi-Encoders based Self-Adaptive Hard Attention Network with Maximum Intensity Projections for Lung Nodule Segmentation in CT Scan

Accurate lung nodule segmentation is crucial for early-stage lung cancer diagnosis, as it can substantially enhance patient survival rates. Computed tomography (CT) images are widely employed for early diagnosis in lung nodule analysis. However, the heterogeneity of lung nodules, size diversity, and the complexity of the surrounding environment pose challenges for developing robust nodule segmentation methods. In this study, we propose an efficient end-to-end framework, the multi-encoder-based self-adaptive hard attention network (MESAHA-Net), for precise lung nodule segmentation in CT scans. MESAHA-Net comprises three encoding paths, an attention block, and a decoder block, facilitating the integration of three types of inputs: CT slice patches, forward and backward maximum intensity projection (MIP) images, and region of interest (ROI) masks encompassing the nodule. By employing a novel adaptive hard attention mechanism, MESAHA-Net iteratively performs slice-by-slice 2D segmentation of lung nodules, focusing on the nodule region in each slice to generate 3D volumetric segmentation of lung nodules. The proposed framework has been comprehensively evaluated on the LIDC-IDRI dataset, the largest publicly available dataset for lung nodule segmentation. The results demonstrate that our approach is highly robust for various lung nodule types, outperforming previous state-of-the-art techniques in terms of segmentation accuracy and computational complexity, rendering it suitable for real-time clinical implementation.