COVID-19 lung infection segmentation with a novel two-stage cross-domain transfer learning framework

•We propose a novel two-stage transfer learning framework for segmenting COVID-19 lung infections from CT images. Our framework learns valuable knowledge from both natural images and CT images with pulmonary nodules, allowing more effective network training for improved performance.•We propose an effective infection segmentation network, called nCoVSegNet, which takes advantage of attention-aware feature fusion and large reception fields for accurate segmentation of lung infections.•Extensive experiments on two COVID-19 CT datasets demonstrate that our framework is able to segment lung infections accurately and outperforms state-of-the-art methods remarkably. [Display omitted] With the global outbreak of COVID-19 in early 2020, rapid diagnosis of COVID-19 has become the urgent need to control the spread of the epidemic. In clinical settings, lung infection segmentation from computed tomography (CT) images can provide vital information for the quantification and diagnosis of COVID-19. However, accurate infection segmentation is a challenging task due to (i) the low boundary contrast between infections and the surroundings, (ii) large variations of infection regions, and, most importantly, (iii) the shortage of large-scale annotated data. To address these issues, we propose a novel two-stage cross-domain transfer learning framework for the accurate segmentation of COVID-19 lung infections from CT images. Our framework consists of two major technical innovations, including an effective infection segmentation deep learning model, called nCoVSegNet, and a novel two-stage transfer learning strategy. Specifically, our nCoVSegNet conducts effective infection segmentation by taking advantage of attention-aware feature fusion and large receptive fields, aiming to resolve the issues related to low boundary contrast and large infection variations. To alleviate the shortage of the data, the nCoVSegNet is pre-trained using a two-stage cross-domain transfer learning strategy, which makes full use of the knowledge from natural images (i.e., ImageNet) and medical images (i.e., LIDC-IDRI) to boost the final training on CT images with COVID-19 infections. Extensive experiments demonstrate that our framework achieves superior segmentation accuracy and outperforms the cutting-edge models, both quantitatively and qualitatively.