FF Swin-Unet: a strategy for automated segmentation and severity scoring of NAFLD

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is a significant risk factor for liver cancer and cardiovascular diseases, imposing substantial social and economic burdens. Computed tomography (CT) scans are crucial for diagnosing NAFLD and assessing its severity. However, current manu...

Full description

Saved in:
Bibliographic Details
Main Authors: Liting Fan, Yi Lei, Feng Song, Xiangfei Sun, Zhuowei Zhang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Medical Imaging
Subjects:
Online Access:https://doi.org/10.1186/s12880-025-01805-y
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849235619026305024
author Liting Fan
Yi Lei
Feng Song
Xiangfei Sun
Zhuowei Zhang
author_facet Liting Fan
Yi Lei
Feng Song
Xiangfei Sun
Zhuowei Zhang
author_sort Liting Fan
collection DOAJ
description Abstract Background Non-alcoholic fatty liver disease (NAFLD) is a significant risk factor for liver cancer and cardiovascular diseases, imposing substantial social and economic burdens. Computed tomography (CT) scans are crucial for diagnosing NAFLD and assessing its severity. However, current manual measurement techniques require considerable human effort and resources from radiologists, and there is a lack of standardized methods for classifying the severity of NAFLD in existing research. Methods To address these challenges, we propose a novel method for NAFLD segmentation and automated severity scoring. The method consists of three key modules: (1) The Semi-automatization nnU-Net Module (SNM) constructs a high-quality dataset by combining manual annotations with semi-automated refinement; (2) The Focal Feature Fusion Swin-Unet Module (FSM) enhances liver and spleen segmentation through multi-scale feature fusion and Swin Transformer-based architectures; (3) The Automated Severity Scoring Module (ASSM) integrates segmentation results with radiological features to classify NAFLD severity. These modules are embedded in a Flask-RESTful API-based system, enabling users to upload abdominal CT data for automated preprocessing, segmentation, and scoring. Results The Focal Feature Fusion Swin-Unet (FF Swin-Unet) method significantly improves segmentation accuracy, achieving a Dice similarity coefficient (DSC) of 95.64% and a 95th percentile Hausdorff distance (HD95) of 15.94. The accuracy of the automated severity scoring is 90%. With model compression and ONNX deployment, the evaluation speed for each case is approximately 5 seconds. Compared to manual diagnosis, the system can process a large volume of data simultaneously, rapidly, and efficiently while maintaining the same level of diagnostic accuracy, significantly reducing the workload of medical professionals. Conclusions Our research demonstrates that the proposed system has high accuracy in processing large volumes of CT data and providing automated NAFLD severity scores quickly and efficiently. This method has the potential to significantly reduce the workload of medical professionals and holds immense clinical application potential.
format Article
id doaj-art-720caaf9dd76436494f6f4a30dcc47ec
institution Kabale University
issn 1471-2342
language English
publishDate 2025-07-01
publisher BMC
record_format Article
series BMC Medical Imaging
spelling doaj-art-720caaf9dd76436494f6f4a30dcc47ec2025-08-20T04:02:44ZengBMCBMC Medical Imaging1471-23422025-07-0125111610.1186/s12880-025-01805-yFF Swin-Unet: a strategy for automated segmentation and severity scoring of NAFLDLiting Fan0Yi Lei1Feng Song2Xiangfei Sun3Zhuowei Zhang4School of Basic Medicine, Shanxi Medical UniversitySchool of Software Engineering, Faculty of Information Technology, Beijing University of TechnologySchool of Basic Medicine, Shanxi Medical UniversityShanxi Key Laboratory of Big Data for Clinical Decision Research, School of Management, Shanxi Medical UniversityCollege of Medical Imaging, Shanxi Medical UniversityAbstract Background Non-alcoholic fatty liver disease (NAFLD) is a significant risk factor for liver cancer and cardiovascular diseases, imposing substantial social and economic burdens. Computed tomography (CT) scans are crucial for diagnosing NAFLD and assessing its severity. However, current manual measurement techniques require considerable human effort and resources from radiologists, and there is a lack of standardized methods for classifying the severity of NAFLD in existing research. Methods To address these challenges, we propose a novel method for NAFLD segmentation and automated severity scoring. The method consists of three key modules: (1) The Semi-automatization nnU-Net Module (SNM) constructs a high-quality dataset by combining manual annotations with semi-automated refinement; (2) The Focal Feature Fusion Swin-Unet Module (FSM) enhances liver and spleen segmentation through multi-scale feature fusion and Swin Transformer-based architectures; (3) The Automated Severity Scoring Module (ASSM) integrates segmentation results with radiological features to classify NAFLD severity. These modules are embedded in a Flask-RESTful API-based system, enabling users to upload abdominal CT data for automated preprocessing, segmentation, and scoring. Results The Focal Feature Fusion Swin-Unet (FF Swin-Unet) method significantly improves segmentation accuracy, achieving a Dice similarity coefficient (DSC) of 95.64% and a 95th percentile Hausdorff distance (HD95) of 15.94. The accuracy of the automated severity scoring is 90%. With model compression and ONNX deployment, the evaluation speed for each case is approximately 5 seconds. Compared to manual diagnosis, the system can process a large volume of data simultaneously, rapidly, and efficiently while maintaining the same level of diagnostic accuracy, significantly reducing the workload of medical professionals. Conclusions Our research demonstrates that the proposed system has high accuracy in processing large volumes of CT data and providing automated NAFLD severity scores quickly and efficiently. This method has the potential to significantly reduce the workload of medical professionals and holds immense clinical application potential.https://doi.org/10.1186/s12880-025-01805-yNon-alcoholic fatty liver disease(NAFLD)CT imagesDeep learningInstance segmetationSeverity scoringAided diagnosis
spellingShingle Liting Fan
Yi Lei
Feng Song
Xiangfei Sun
Zhuowei Zhang
FF Swin-Unet: a strategy for automated segmentation and severity scoring of NAFLD
BMC Medical Imaging
Non-alcoholic fatty liver disease(NAFLD)
CT images
Deep learning
Instance segmetation
Severity scoring
Aided diagnosis
title FF Swin-Unet: a strategy for automated segmentation and severity scoring of NAFLD
title_full FF Swin-Unet: a strategy for automated segmentation and severity scoring of NAFLD
title_fullStr FF Swin-Unet: a strategy for automated segmentation and severity scoring of NAFLD
title_full_unstemmed FF Swin-Unet: a strategy for automated segmentation and severity scoring of NAFLD
title_short FF Swin-Unet: a strategy for automated segmentation and severity scoring of NAFLD
title_sort ff swin unet a strategy for automated segmentation and severity scoring of nafld
topic Non-alcoholic fatty liver disease(NAFLD)
CT images
Deep learning
Instance segmetation
Severity scoring
Aided diagnosis
url https://doi.org/10.1186/s12880-025-01805-y
work_keys_str_mv AT litingfan ffswinunetastrategyforautomatedsegmentationandseverityscoringofnafld
AT yilei ffswinunetastrategyforautomatedsegmentationandseverityscoringofnafld
AT fengsong ffswinunetastrategyforautomatedsegmentationandseverityscoringofnafld
AT xiangfeisun ffswinunetastrategyforautomatedsegmentationandseverityscoringofnafld
AT zhuoweizhang ffswinunetastrategyforautomatedsegmentationandseverityscoringofnafld