Volume 10, Issue 2, February – 2025 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165 https://doi.org/10.5281/zenodo.14928626

Comprehensive Review of Medical Image

Segmentation Topologies
Ramesh Malyala1
1
(Assistant Professor) Department of Electronics and Communication Engineering Methodist College of
Engineering and Technology Abids, Hyderabad

Publication Date: 2025/02/25

Abstract: Image segmentation is a crucial aspect of medical image analysis, primarily used to identify and evaluate affected
tumors. It involves dividing an image into distinct regions that share similar features, allowing for the extraction of valuable
information. A variety of image segmentation techniques have been developed, addressing the limitations of traditional
medical segmentation methods. This paper reviews medical image segmentation techniques and the use of statistical
mechanics through a novel approach known as the Lattice Boltzmann method (LBM). LBM is particularly advantageous
due to its ability to significantly enhance computational speed in medical image segmentation while maintaining over 95%
accuracy and specificity, outperforming conventional techniques. Given the limited research on LBM in medical physics,
this paper aims to provide an overview of the progress made in this area.

Keywords: Segmentation, Computed Tomography, Magnetic Resonance Imaging, Image Processing, Image Analysis, Lattice Boltz
Man Method.

How to Cite: Ramesh Malyala (2025). Comprehensive Review of Medical Image Segmentation Topologies International Journal
of Innovative Science and Research Technology, 10(2), 1881-1892.
https://doi.org/10.5281/zenodo.14928626

I. INTRODUCTION

Image processing techniques have gained increasing accuracy of dose computations, both of which are tightly
importance across a wide range of applications, driven by interrelated. The goal of image segmentation is to break down
advanced methods and tools. Among these techniques, image medical images into distinct components or objects with
segmentation stands out as a key area of focus. It involves similar and consistent features. One of these features could be
dividing an image into distinct regions that are homogeneous intensity or color, which helps identify anatomical structures,
in specific features, allowing for the extraction of valuable tumors, etc. The extent of segmentation depends on the
information. Image segmentation plays a crucial role in image specific application, and no single, universal theory for image
analysis. In particular, medical imaging is vital to healthcare, segmentation exists. Numerous segmentation methods and
contributing significantly to the field[1]. algorithms have been proposed in the literature to overcome
the limitations of traditional medical segmentation techniques.
The quality of medical images plays a crucial role in The choice of a specific method or algorithm depends on the
diagnosis and treatment. Segmentation is an essential step in type and nature of the image involved[3].
medical image analysis, designed to extract key details from
images, enabling advanced understanding and interpretation. Recent developments in image segmentation techniques
In scientific terms, segmentation is a mid-level vision task have been frequently reviewed, with a focus on categorizing
carried out by neurons, bridging low-level and high-level methods based on the type of data they process (e.g., pixel or
cortical processes, as shown schematically in Figure 1. For voxel data) and their applications in diagnosis, treatment
clinical images, segmentation aims to identify anatomical planning, and follow-up. However, a notable challenge
structures and delineate their boundaries in digital form. This remains in the speed of computation. This paper provides a
is particularly vital in Radiotherapy (RT), where imaging is an brief review of various medical image segmentation
integral part of the therapy process, helping identify the techniques, including thresholding, region-based methods,
treatment target and surrounding healthy tissues to avoid
clustering, edge detection, model-based approaches, and the
unnecessary radiation exposure. Consequently, Radiotherapy
novel Lattice Boltzmann Method (LBM). The LBM, which is
Treatment Planning Systems (RTPS) require accurate
anatomical data from CT scans to outline the treatment target rooted in a microscopic understanding of macroscopic
and normal structures, with clinicians manually marking these physical processes, aims to enhance computational efficiency.
areas[2]. Segmented images are then transferred to RTPS for As there is no existing review on the progress of LBM in
radiation dose calculation, making precise segmentation medical image segmentation, this paper presents an overview
essential for the success of patient treatment. In radiotherapy, of this novel approach and encourages further exploration of
segmentation quality directly affects spatial precision and the LBM in medical image segmentation research[4].

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ISSN No:-2456-2165 https://doi.org/10.5281/zenodo.14928626

Fig 1 Image Engineering and Image Segmentation

II. SEGMENTATION TECHNIQUES IV. REGION-BASED METHODS

Recently, significant efforts have been focused on There are three key techniques for region-based image
improving the image segmentation process. Various segmentation.
segmentation methods and algorithms have been discussed in
the literature, each addressing the limitations of traditional  Region Growing
medical segmentation techniques. However, there is no single In region growing algorithms, the segmentation process
"best" method suitable for all types of images; each technique starts from a specific seed pixel, and the region's growth
is tailored to specific images and applications. Image depends on the connectivity of neighboring pixels. This
segmentation techniques can be broadly categorized into connectivity is based on similarity criteria, such as grayscale
Thresholding, Region Growing & Region Splitting and intensity, shape, size, or color, which are defined by thresholds
Merging, Clustering, Edge Detection, and Model-based to guide the expansion of the region . The choice of the seed
methods. All segmentation techniques rely on two point and the similarity criteria directly influences the
fundamental principles: intensity values and image segmentation results. By incorporating statistical information
characteristics such as discontinuity and similarity. The and prior knowledge, these algorithms can adapt based on the
discontinuity-based approach segments an image by initial seed points, making the method more flexible and
identifying sudden changes in intensity or grayscale levels, dynamic[6]
focusing primarily on detecting isolated points. In contrast,
similarity-based techniques segment the image by grouping  Region Split and Merge Approach
pixels that share similar values within a predefined range, The second region-based technique is the split and
with methods like Thresholding, Region Growing, and merge method. This approach uses a quadtree representation
Region Splitting and Merging falling under this category[5]. of the image, where the image is recursively divided into four
quadrants. Each split takes into account the non-uniform
III. THRESHOLDING characteristics of the image segment. When neighboring
image regions are found to be uniform, they are merged into
Thresholding is one of the fundamental methods used in a single image composed of the four neighboring segments.
image segmentation, where a single threshold value is applied The process continues until no further merging is possible.
to convert a grayscale image into a binary image. The key This method effectively reduces high-frequency artifacts, and
aspect of this process is selecting an appropriate threshold the selection of seed points relies on local statistical
value (T). Pixels with intensities above this threshold are information. It is commonly used for evaluating specific
categorized as part of the foreground, while all other pixels are regions, such as breast tissue or cyst masses. These
considered part of the background region. Several well-known algorithms mainly depend on image intensity data to address
techniques are commonly used in the industry, including "The partial volume effects and prevent leakage[7].
Maximum Entropy Method", Otsu's method (which
maximizes variance), and K-means clustering. While  Watershed Approach
Thresholding segmentation performs effectively on images Another region-based segmentation technique is the
with sharp edges, it can be affected by noise and unclear Watershed method, which treats the image as a topographic
boundaries. To mitigate the influence of noise, two common surface. In this approach, low-intensity pixels are interpreted
strategies are used: smoothing the image before applying as valleys, while high-intensity pixels are seen as hills or
Thresholding, and combining Thresholding with Edge peaks. The algorithm begins by filling the valleys from local
Detection techniques. minima, with seeds acting as water sources. Each seed is
assigned a unique color, and the water from these seeds floods

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ISSN No:-2456-2165 https://doi.org/10.5281/zenodo.14928626
the surrounding regions. As the water from different seeds algorithm, allows a pixel to belong to more than one cluster.
meets, a barrier is formed to prevent the merging of different The degree to which a pixel belongs to a particular cluster is
regions, known as the watershed lines. This process continues determined by a fuzzy membership function, with values
until all peaks are submerged, and the barriers formed during ranging between 0 and 1. When a pixel’s position is close to
the flooding process define the segmentation boundaries[8]. the centroid of a cluster, it can be assigned to that cluster if
the membership function value approaches.[13]
The Watershed algorithm combines information from
both the gradient and grayscale levels of the image. The The objective function in FCM is defined as the
regions where water accumulates around local minima are summation of the squared Euclidean distances between each
called "catchment basins." The pixels in the grayscale image sample and its corresponding cluster center, weighted by the
are treated as "water droplets," and the outcome of the fuzzy membership distances. The FCM algorithm is used to
catchment basins corresponds to segments of the image with partition both grayscale and color images, with the number of
similar pixel characteristics. There are two primary clusters typically set in advance. If there is a deviation from
algorithmic processes used in the watershed method to handle the expected value, it can indicate potential shortcomings in
the image[9] the segmentation process.[14]

 Flooding in the Watershed Approach One of the strengths of FCM is its flexibility, as the
In the Watershed algorithm's rainfall process, local objective function can be adjusted and extended to meet
minima across the image are identified. Each local minimum specific requirements. This variability makes FCM suitable
is assigned a unique label, and neighboring pixels are linked for a wide range of image types. Additionally, the FCM
to this label. A hypothetical water droplet is placed at each algorithm includes mechanisms to assess the validity of the
unmarked pixel, and it flows toward neighboring pixels with clustering results, making it a robust tool for segmentation
the lowest intensity, continuing until it reaches a marked tasks.[15]
pixel, at which point it adopts that marked value. During the
flooding process, a single droplet is placed at each The objective of clustering is to minimize
neighborhood minimum, and a flood of pixels expands computational effort while achieving satisfactory results.
outward from the pixel at the minimum. If the flood Refinements to the Fuzzy C-Means (FCM) algorithm have
continues, excess pixels are discarded, and the process been made to improve its performance. Traditional FCM
repeats. However, this method may not be effective for algorithms are sensitive to noise, especially in medical
images with weak boundaries[10]. images like MR scans, where intensity heterogeneities may
complicate segmentation. To address this, the Euclidean
The standard Watershed method is susceptible to over- distance in FCM is replaced with a kernel-induced distance,
segmentation, particularly when images contain noise or resulting in the Kernelized Fuzzy C-Means (KFCM)
when the objects within the image have a low signal-to-noise algorithm. This modification enhances robustness by
ratio. Over-segmentation can be minimized by applying incorporating kernel methods to better handle variations in
appropriate filtering techniques, which remove irrelevant image intensity[16].
local minima. To overcome the challenges of traditional
Watershed algorithms, enhanced versions, such as power Additionally, a Fast Generalized Fuzzy C-Means
watershed algorithms, have been developed, offering more (FGFCM) algorithm has been introduced, which integrates
precise segmentation results[11]. both local spatial and grayscale information. This approach
effectively suppresses noise while preserving important
These advanced algorithms combine the benefits of image details, making it especially useful for medical
unsupervised neural network (NN) classification with imaging tasks. Various improvements have been tested,
morphological Watershed segmentation, improving the including the evaluation of these algorithms on CT brain
accuracy of breast tumor contour detection in ultrasound images to identify abnormal regions and on bacterial images
images. A newer variant, the stochastic watershed approach, to separate bacteria from the background. The results showed
has been applied to enhance the accuracy of contour that T2FCM (Type-II Fuzzy C-Means) efficiently removed
detection. By tuning optimal parameters through training, this noise, although it slightly increased the size of the segmented
method has demonstrated strong performance on 17 data sets, objects. IFCM (Intuitionistic Fuzzy C-Means) outperformed
proving to be a robust tool for automatic liver segmentation, other methods in terms of segmentation accuracy.[17]
outperforming other approaches. Additionally, marker-
controlled watershed algorithms, combined with distinctive In another innovation, the Fuzzy-Based Artificial Bee
feature combinations, have been successfully used for tumor Colony (FABC) algorithm was proposed, which combines
extraction in brain MRI images.[12] Artificial Bee Colony (ABC) Optimization with Fuzzy C-
Means (FCM). This approach uses the fuzzy membership
V. CLUSTERING APPROACH function to optimize cluster centers through the ABC
algorithm. When tested on synthetic and medical images, the
Clustering refers to the process of grouping results demonstrated that FABC outperforms other
homogeneous data into clusters based on similarity criteria. segmentation methods in terms of efficiency.[18]
One of the most commonly used clustering algorithms is "K-
means clustering" (hard clustering), where each data point Lastly, the ARKFCM (Adaptable Regularized Kernel
belongs exclusively to one cluster. In contrast, the soft Fuzzy C-Means) algorithm was introduced for brain MRI
clustering approach, such as the Fuzzy C-Means (FCM) segmentation. This customizable, regularized kernel-based

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ISSN No:-2456-2165 https://doi.org/10.5281/zenodo.14928626
method improves the algorithm’s robustness, helping to distribution of the next state, is referred to as a Markov
preserve important image details and adapt to the complexity Random Field (MRF). The MRF model is inspired by the
of medical images.[19] Ising model and has been widely applied in image
segmentation tasks due to its ability to preserve edges while
VI. EDGE DETECTION approximating image parameters effectively.[24]

Edge detection is one of the most traditional methods A key variant of MRF is the Hidden Markov Random
used to identify irregularities or boundaries in an image. The Field (HMRF) model [31]. In HMRF, the states of the system
boundary or transition between two regions with distinct are not directly observable, but can be inferred through
intensity levels or grayscale values is known as an edge. analysis. Mathematically, the FM model can be considered a
Detecting these edges is crucial for various applications, degraded version of the HMRF model. By integrating the
including image enhancement, as it helps to highlight HMRF model with the Expectation-Maximization (EM)
important details of an image. To detect edges, derivative algorithm into an HMRF-EM framework, researchers have
operations are commonly used. Specifically, a convolution achieved more precise and robust segmentation results. This
function is applied to the image using an appropriate approach has been compared to traditional FM model-based
mask.[20] segmentation techniques, demonstrating improved accuracy.

One of the most effective edge detectors is the Canny Further advancements include the combination of MRF
edge detector, which improves edge detection by using with Self-Organizing Feature Maps (SOFM), which
gradient magnitude thresholds to identify potential edges. It incorporates spatial constraints to enhance the smoothness of
then refines these edges through non-maximal suppression image partitioning. Additionally, the use of Pickard Random
and hysteresis thresholding. These processes help to suppress Fields (PRF), an unsupervised variant of MRF, has been
weak or irrelevant edge candidates, ensuring that only the explored for mass breast segmentation. The PRF model has
most significant edges remain.[21] shown to be more efficient than traditional MRF in terms of
computational complexity, providing a more practical
However, noise in the image can have a significant solution for certain applications.[25]
impact on edge detection, often leading to fragmented or
irregular edges that are not representative of the actual In summary, MRF-based models, including their
boundaries. To mitigate this, the image is typically smoothed variants like HMRF and PRF, offer powerful tools for image
using a Gaussian operator before edge detection is performed. segmentation, particularly in preserving structural details
This smoothing process helps to reduce noise, but it can also such as edges, while also benefiting from advanced
lead to false edge detections if not applied properly. To algorithms that improve computational efficiency and
address this, multi-resolution edge detection and edge tracing accuracy.[26]
techniques can be employed to improve the accuracy and
consistency of the edge detection process.[22]  Artificial Neural Networks
Artificial Neural Networks (ANNs) are mathematical
VII. MODEL-BASED ALGORITHMS models inspired by the structure and function of the human
brain's neurons. Each node in an ANN function like a neuron
Model-based algorithms have emerged as some of the and is connected to other nodes via communication links,
most effective strategies for image analysis, particularly with each link having a synaptic weight. The inputs to these
when working with predefined models. These models are synaptic weights are processed through an activation function
constructed based on prior knowledge and contain to classify or identify objects within the image.
information about the expected features or structures in the
image, such as the shape, texture, or behavior of the objects Two key features of ANNs are training and learning. In
being analyzed. The core idea behind model-based the training phase, the network is fed with attributes, often
approaches is to match or fit these models to the data in the statistical in nature, such as mean, standard deviation,
image to extract meaningful information.[23] kurtosis, skewness, or transformed features obtained through
Wavelet or Curvelet transforms. This phase, referred to as the
By using a model, these algorithms can incorporate "speculating phase," progresses until the network reaches a
prior knowledge, making them more robust in situations steady state, providing acceptable results based on the images
where simple pixel-based methods might struggle. This is being analyzed. During the learning phase, the weights
especially useful when dealing with complex images or in between the interconnected neurons are adjusted to improve
cases where there is limited contrast or noisy data. The model the network's performance by providing appropriate
can be adapted or optimized based on the specific feedback. Learning in ANNs can be either supervised or
characteristics of the image, allowing for more accurate unsupervised. [27]
segmentation and detection of objects or anomalies.[24]
However, one of the challenges in using neural
 Markov Random Field Models networks is determining the appropriate architecture,
Markov Random Field (MRF) models are a type of including the network size, type, number of layers, and the
stochastic process where the distribution of future states overall structure. The selection of these components
depends solely on the current state, and not on how the system significantly influences the performance of the network in
arrived at that state. An image sequence that follows this solving specific problems.
Markov property, where the current state dictates the

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ISSN No:-2456-2165 https://doi.org/10.5281/zenodo.14928626
In medical imaging, ANNs have been applied in various in this context, including truncated quadratic energy
tasks. For instance, the Group Method of Data Handling functions and models like the Potts model, which apply
(GMDH) has been used to identify lungs in clinical images penalties to smoothness in the segmentation process. The
Fuzzy neural networks have been shown to yield better results of these techniques are often compared against
segmentation results, especially in noisy environments different annealing variants to assess their effectiveness.
Additionally, the use of Support Vector Machine (SVM)
classifiers in conjunction with ANN segmentation techniques One notable advantage of the graph cut algorithm is its
has proven effective, with the added benefit of reduced ability to provide optimal segmentation when prior
processing time and memory usage.[28] information about the foreground shape is available. For
multi-region graph cut partitioning, a kernel mapping
In the context of liver malignancy detection, a approach is used to transform image data. The objective
combination of the 3D fast marching algorithm and a single function incorporates original data to evaluate the deviations
hidden layer feed-forward neural network was used for the of the modified image, with the optimization algorithm
segmentation of liver cancer from MR images. The results iterating between graph cut optimization and fixed-point
were validated against radiologist-delineated ground truth iterations to update the region parameters. This approach has
images and showed reduced time complexity and increased shown powerful performance compared to more complex
accuracy compared to other semi-automatic segmentation modeling methods, while still benefiting from the
techniques. computational efficiency of graph cuts.

Moreover, Deep Convolutional Neural Networks This method has been validated and quantitatively
(DCNNs) have been successfully employed to detect compared using synthetic, natural, and medical images.
glioblastomas in brain MR images, further demonstrating the Kernel mapping, in particular, has produced promising results
power of neural networks in medical image segmentation and in multi-region partitioning of brain MR images, showcasing
analysis. the versatility and effectiveness of the graph cut approach in
medical image segmentation.
 Graph Cut Approach
The fundamental concept of the graph cut algorithm  Lattice Boltzmann Method (LBM)
involves applying tools from graph theory to partition an The Lattice Boltzmann Method (LBM) is a powerful
image into foreground and background regions. In graph simulation technique that offers high accuracy, widely
theory, each pixel in the image is represented as a node, and applied in kinetic theory for simulating various systems [32].
the edges between these nodes represent the connections, It operates by providing a microscopic understanding of
with weights corresponding to the probability of a node being macroscopic physical processes. LBM seeks to bridge the gap
part of the foreground or background. These connections are between macroscopic and microscopic scales by considering
made to a source (S) or sink (T), with the weights acting as the behavior of a group of particles rather than individual
the probability of the pixel being assigned to either segment. particles. This method models the movement of particles on
The algorithm promotes the similarity of pixels within the a lattice grid, capturing both local interactions and the
same segment, while encouraging dissimilar pixels to belong macroscopic behavior of fluids or other media. LBM has
to different segments.[29] proven to be effective in simulating fluid dynamics, heat
transfer, and other physical phenomena, making it an
Once the graph is constructed, the goal is to partition it attractive approach for a range of applications, including
by creating a minimal cut that divides the foreground from medical image segmentation.[31]
the background, requiring the least amount of effort. The
segmentation process considers both hard constraints (such as  Lattice Boltzmann Method (LBM) in Image Segmentation
known boundaries or region properties) and soft constraints The Lattice Boltzmann Method (LBM) is a simulation
(which relate to the region's general characteristics). When technique that operates by considering the behavior of a
hard constraints are modified, the global optimization is collection of particles rather than tracking individual
recalculated based on the updated cost function, ensuring the particles. In this method, the solution area is divided into
segmentation remains accurate. lattices, and particle distributions reside at each lattice node.
These particles move in specific directions, determined by the
In the graph cut algorithm, the nodes represent the lattice alignment. The model is typically represented as
pixels, and the edges represent the weighted connections DnQm, where "n" indicates the problem’s dimension and "m"
between them. By computing the global optimal minimum refers to the number of directions or linkages in the
cut, the algorithm separates the object (foreground) from the lattice.[32]
background within the image. This technique has been
successfully applied to fields such as photo and video editing A core aspect of LBM is the equilibrium distribution
as well as medical image processing.[30] function and the relaxation time (τ), which defines the type of
problem being addressed. LBM provides an alternative to
Several algorithms have been proposed to minimize the conventional mathematical methods for solving partial
energy function within graph cuts. The first algorithm differential equations (PDEs). It offers faster computation,
performs labeling among a set of arbitrary pixels, allowing requires less memory, and is well-suited for parallel
for movement between these labeled pixels to minimize computation due to its particle-based approach. This makes
energy. The second algorithm requires smoothing to refine LBM particularly efficient in applications such as image
the segmentation. Various energy functions have been used analysis.

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 In the context of image processing, LBM operates in two values are treated as particle densities, and changes in pixel
primary stages: values correspond to particle redistribution. The process is
influenced by relaxation time, which determines the nature of
 Streaming Stage: Particles or particle densities move from the problem being addressed. Additionally, the inclusion of a
one node to another across the lattice. source term makes the LBM method directly applicable to a
 Collision Stage: Particles or densities are reorganized at wide range of image segmentation tasks. This approach
each node. shows promising potential for further research and
development, particularly in medical image analysis.
These stages are governed by the LBM evolution
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