As an essential indicator for cancer progression and treatment response, tumor size is often measured following the response evaluation criteria in solid tumors (RECIST) guideline in CT slices. By marking each lesion with its longest axis and the longest perpendicular one, laborious pixel-wise manual annotation can be avoided. However, such a coarse substitute cannot provide a rich and accurate base to allow versatile quantitative analysis of lesions. To this end, we propose a novel weakly supervised framework to exploit the existing rich RECIST annotations for pixel-wise lesion segmentation. Specifically, a pair of under- and over-segmenting masks are constructed for each lesion based on its RECIST annotation and served as the label for co-training a pair of subnets, respectively, along with the proposed label-space perturbation induced consistency loss to bridge the gap between the two subnets and enable effective co-training. Extensive experiments are conducted on a public dataset to demonstrate the superiority of the proposed framework regarding the RECIST-based weakly supervised segmentation task and its universal applicability to various backbone networks.
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