Weakly SSM : On the Viability of Weakly Supervised Segmentations for Statistical Shape Modeling

Statistical Shape Models (SSMs) excel at identifying population level anatomical variations, which is at the core of various clinical and biomedical applications, including morphology-based diagnostics and surgical planning. However, the effectiveness of SSM is often constrained by the necessity for expert-driven manual segmentation, a process that is both time-intensive and expensive, thereby restricting their broader application and utility. Recent deep learning approaches enable the direct estimation of Statistical Shape Models (SSMs) from unsegmented images. While these models can predict SSMs without segmentation during deployment, they do not address the challenge of acquiring the manual annotations needed for training, particularly in resource-limited settings. Semi-supervised and foundation models for anatomy segmentation can mitigate the annotation burden. Yet, despite the abundance of available approaches, there are no established guidelines to inform end-users on their effectiveness for the downstream task of constructing SSMs. In this study, we systematically evaluate the potential of weakly supervised methods as viable alternatives to manual segmentation's for building SSMs. We establish a new performance benchmark by employing various semi-supervised and foundational model methods for anatomy segmentation under low annotation settings, utilizing the predicted segmentation's for the task of SSM. We compare the modes of shape variation and use quantitative metrics to compare against a shape model derived from a manually annotated dataset. Our results indicate that some methods produce noisy segmentation, which is very unfavorable for SSM tasks, while others can capture the correct modes of variations in the population cohort with 60-80\% reduction in required manual annotation.