Beyond automatic medical image segmentation - the spectrum between fully manual and fully automatic delineation

Michael Johann Trimpl*, Sergey Primakov, Philippe Lambin, Eleanor Stride, Katherine Anne Vallis, Mark J Gooding

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review


Semi-automatic and fully automatic contouring tools have emerged as an alternative to fully manual segmentation to reduce time spent contouring and to increase contour quality and consistency. Particularly, fully automatic segmentation has seen exceptional improvements through the use of deep learning in recent years. These fully automatic methods may not require user interactions, but the resulting contours are often not suitable to be used in clinical practice without a review by the clinician. Furthermore, they need large amounts of labeled data to be available for training. This review presents alternatives to manual or fully automatic segmentation methods along the spectrum of variable user interactivity and data availability. The challenge lies to determine how much user interaction is necessary and how this user interaction can be used most effectively. While deep learning is already widely used for fully automatic tools, interactive methods are just at the starting point to be transformed by it. Interaction between clinician and machine, via artificial intelligence, can go both ways and this review will present the avenues that are being pursued to improve medical image segmentation.

Original languageEnglish
Article numberARTN 12TR01
Number of pages16
JournalPhysics in Medicine and Biology
Issue number12
Early online date6 May 2022
Publication statusPublished - 21 Jun 2022


  • DEEP
  • automatic
  • deep learning
  • few-shot
  • interactive
  • medical image segmentation
  • semi-automatic
  • transfer learning
  • Transfer learning
  • Few-shot
  • Medical image segmentation
  • Deep learning
  • Interactive
  • Semi-automatic
  • Automatic

Cite this