Point-Supervised Coronary Semantic Segmentation in X-Ray Angiographic Images

Abstract

Coronary semantic segmentation in X-ray angiography is essential for computer-aided diagnosis and treatment planning of coronary artery disease (CAD). Despite its importance, this task remains highlychallenging due to the complex and interconnected vascular topology, as well as the similar visual characteristics among different branches, making dense pixel-level manual annotation difficult and labor-intensive. To alleviate this burden, we propose a point-supervised coronary semantic segmentation framework that significantly reduces annotation effort without compromising segmentation accuracy. The primary challenge of point label based supervision lies in the model's tendency to overfit sparse point labels, leading to limited generalization to pixel-level predictions. To enrich the supervision signals and stabilize the training process with the sparse point labels, we propose an adaptive foreground mask generation module and a region regularization strategy to ensure accurate semantic guidance while maximizing meaningful coverage of the vascular structures. To enhance coronary topology perception and branch differentiation, we propose a multi-task learning framework that jointly performs keypoint detection and coronary semantic segmentation through a shared feature extraction encoder and two task-specific decoders. The experimental results demonstrate that our point-supervised model achieves performance comparable to fully supervised model, and outperforms the existing state-of-the-art point-supervised semantic segmentation methods.