Bottom-Up Instance Segmentation of Catheters for Chest X-Rays

Chest X-ray (CXR) is frequently employed in emergency departments and intensive care units to verify the proper placement of central lines and tubes and to rule out related complications. The automation of the X-ray reading process can be a valuable support tool for non-specialist technicians and minimize reporting delays due to non-availability of experts. While existing solutions for automated catheter segmentation and malposition detection show promising results, the disentanglement of individual catheters remains an open challenge, especially in complex cases where multiple devices appear superimposed in the X-ray projection. Moreover, conventional top-down instance segmentation methods are ineffective on such thin and long devices, that often extend through the entire image. In this paper, we propose a deep learning approach based on associative embeddings for catheter instance segmentation, able to overcome those limitations and effectively handle device intersections.