Additional file 1 of Lung lobe segmentation: performance of open-source MOOSE, TotalSegmentator, and LungMask models compared to a local in-house model

Additional file 1: Table S1. Criteria used to assign a segmentation difficulty category to each chest CT scan. Fig. S1. Flowchart illustrating the data collection process, including the total number of cases initially collected, the exclusion criteria applied, and the final dataset used for analysis. Fig. S2. Boxplots displaying the performance metrics for open-source models across different difficulty categories for all lobes combined. From left to right, the box plots represent the performance evaluated using the DSC, rHd95, and NSD metrics, respectively. All p-values are after a Bonferroni correction factor of 3 was applied (n = 129 images; 42 Easy, 41 moderate, and 46 hard, ×5 segments per image). Fig. S3. Comparative analysis of segmentation accuracy of hard cases from the internal test set (n = 16), specifically those without missing lobes (n = 9) and those with missing lobes (n = 7), indicating that missing lobes have a disproportionately large impact on segmentation accuracy for all models except our model. Fig. S4. Bar chart comparing IoU scores for five lung lobes across 55 cases from the LOLA11 dataset. The chart is divided into two panels: Cases 1−28 and Cases 29−55. Each bar represents the IoU score for a specific lobe (LUL, LLL, RUL, RML, RLL) in each case, with scores ranging from -1.0 to 1.0, where -1.0 indicates excluded evaluations, 0 indicates no overlap, and 1.0 indicates perfect overlap between the model prediction and the ground truth. IoU, Intersection over union; LLL, Left Lower Lobe; LUL, Left Upper Lobe; RML, Right Middle Lobe; RLL, Right Lower Lobe; RUL, Right Upper Lobe. Fig. S5. Qualitative results showcasing some of the instances of the LOLA11 challenge dataset where our model successfully performed. Conditions included noisy scans, low-resolution images, emphysematous changes, and lesions ranging from small to moderate in size, both cystic and solid. Red arrows indicate areas where the model failed to make accurate predictions. LLL, Left lower lobe; LOLA11, LObe and Lung Analysis 2011; LUL, Left upper lobe; RLL, Right lower lobe; RML, Right middle lobe; RUL, Right upper lobe. Fig. S6. Qualitative results showcasing instances where our model struggled to perform accurately. The conditions and pathologies presented in these cases include disease- and treatment-related missing lobes (cases 44, 45, and 48), disease-related volume loss (cases 06, 20, 31, and 52), large lesions (case 31), and emphysematous changes (case 28). Red arrows indicate areas where the model failed to make accurate predictions, including misidentified fissures, exclusion of high-density parenchymal and pleural regions, and false positive class predictions. LLL, Left lower lobe; LUL, Left upper lobe; RLL, Right lower lobe; RML, Right middle lobe; RUL, Right upper lobe. Fig. S7. Two cases from the LOLA11 challenge where no overlap between our model’s prediction and ground truth annotations was recorded, with an IoU of 0 reported for the RML in case 21, and the LLL in case 52. In case 52, the red arrow highlights the ground truth region labeled as LLL, while the blue arrow indicates the location of the left oblique fissure. This visual interpretation calls into doubt the accuracy of ground truth segmentation and/or annotations in the LOLA11 competition. IoU, Intersection over union; LLL, Left lower lobe; LOLA11, LObe and Lung Analysis 2011; LUL, Left upper lobe; RLL, Right lower lobe; RML, Right middle lobe; RUL, Right upper lobe. Fig. S8. Example slices of LOLA11 challenge cases with missing right lung (case 44), missing left lung (case 45), and missing RML (case 48), demonstrating varying degrees of segmentation accuracy by the four models evaluated. The red arrow indicates a structure resembling the right horizontal fissure. LLL, Left lower lobe; LOLA11, LObe and Lung Analysis 2011; LUL, Left upper lobe; RLL, Right lower lobe; RML, Right middle lobe; RUL, Right upper lobe.

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