Accurate segmentation of lungs in pathological thoracic computed tomography (CT) scans plays an important role in pulmonary disease diagnosis. However, it is still a challenging task due to the variability of pathological lung appearances and shapes. In this paper, we proposed a novel segmentation algorithm based on random forest (RF), deep convolutional network, and multi-scale superpixels for segmenting pathological lungs from thoracic CT images accurately. A pathological thoracic CT image is first segmented based on multi-scale superpixels, and deep features, texture, and intensity features extracted from superpixels are taken as inputs of a group of RF classifiers. With the fusion of classification results of RFs by a fractional-order gray correlation approach, we capture an initial segmentation of pathological lungs. We finally utilize a divide-and-conquer strategy to deal with segmentation refinement combining contour correction of left lungs and region repairing of right lungs. Our algorithm is tested on a group of thoracic CT images affected with interstitial lung diseases. Experiments show that our algorithm can achieve a high segmentation accuracy with an average DSC of 96.45% and PPV of 95.07%. Compared with several existing lung segmentation methods, our algorithm exhibits a robust performance on pathological lung segmentation. Our algorithm can be employed reliably for lung field segmentation of pathologic thoracic CT images with a high accuracy, which is helpful to assist radiologists to detect the presence of pulmonary diseases and quantify its shape and size in regular clinical practices.
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