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In this report, we propose three novel methods for developing a sound event detection (SED) model for the DCASE 2024 Challenge Task 4. First, we propose an auxiliary decoder attached to the final convolutional block to improve feature extraction capabilities while reducing dependency on embeddings from pre-trained large models. The proposed auxiliary decoder operates independently from the main decoder, enhancing performance of the convolutional block during the initial training stages by assigning a different weight strategy between main and auxiliary decoder losses. Next, to address the time interval issue between the DESED and MAESTRO datasets, we propose maximum probability aggregation (MPA) during the training step. The proposed MPA method enables the model's output to be aligned with soft labels of 1 s in the MAESTRO dataset. Finally, we propose a multi-channel input feature that employs various versions of logmel and MFCC features to generate time-frequency pattern. The experimental results demonstrate the efficacy of these proposed methods in a view of improving SED performance by achieving a balanced enhancement across different datasets and label types. Ultimately, this approach presents a significant step forward in developing more robust and flexible SED models, Comment: DCASE 2024 challenge Task4, 4 pages

Interpreting traditional B-mode ultrasound images can be challenging due to image artifacts (e.g., shadowing, speckle), leading to low sensitivity and limited diagnostic accuracy. While Magnetic Resonance Imaging (MRI) has been proposed as a solution, it is expensive and not widely available. Furthermore, most biopsies are guided by Transrectal Ultrasound (TRUS) alone and can miss up to 52% cancers, highlighting the need for improved targeting. To address this issue, we propose ProsDectNet, a multi-task deep learning approach that localizes prostate cancer on B-mode ultrasound. Our model is pre-trained using radiologist-labeled data and fine-tuned using biopsy-confirmed labels. ProsDectNet includes a lesion detection and patch classification head, with uncertainty minimization using entropy to improve model performance and reduce false positive predictions. We trained and validated ProsDectNet using a cohort of 289 patients who underwent MRI-TRUS fusion targeted biopsy. We then tested our approach on a group of 41 patients and found that ProsDectNet outperformed the average expert clinician in detecting prostate cancer on B-mode ultrasound images, achieving a patient-level ROC-AUC of 82%, a sensitivity of 74%, and a specificity of 67%. Our results demonstrate that ProsDectNet has the potential to be used as a computer-aided diagnosis system to improve targeted biopsy and treatment planning., Comment: Accepted in NeurIPS 2023 (Medical Imaging meets NeurIPS Workshop)

Prostate biopsy and image-guided treatment procedures are often performed under the guidance of ultrasound fused with magnetic resonance images (MRI). Accurate image fusion relies on accurate segmentation of the prostate on ultrasound images. Yet, the reduced signal-to-noise ratio and artifacts (e.g., speckle and shadowing) in ultrasound images limit the performance of automated prostate segmentation techniques and generalizing these methods to new image domains is inherently difficult. In this study, we address these challenges by introducing a novel 2.5D deep neural network for prostate segmentation on ultrasound images. Our approach addresses the limitations of transfer learning and finetuning methods (i.e., drop in performance on the original training data when the model weights are updated) by combining a supervised domain adaptation technique and a knowledge distillation loss. The knowledge distillation loss allows the preservation of previously learned knowledge and reduces the performance drop after model finetuning on new datasets. Furthermore, our approach relies on an attention module that considers model feature positioning information to improve the segmentation accuracy. We trained our model on 764 subjects from one institution and finetuned our model using only ten subjects from subsequent institutions. We analyzed the performance of our method on three large datasets encompassing 2067 subjects from three different institutions. Our method achieved an average Dice Similarity Coefficient (Dice) of $94.0\pm0.03$ and Hausdorff Distance (HD95) of 2.28 $mm$ in an independent set of subjects from the first institution. Moreover, our model generalized well in the studies from the other two institutions (Dice: $91.0\pm0.03$; HD95: 3.7$mm$ and Dice: $82.0\pm0.03$; HD95: 7.1 $mm$)., Comment: Accepted to the journal of Medical Image Analysis (MedIA)

Unsupervised domain adaptation (UDA) aims to transfer knowledge learned from a labeled source domain to an unlabeled target domain. Contrastive learning (CL) in the context of UDA can help to better separate classes in feature space. However, in image segmentation, the large memory footprint due to the computation of the pixel-wise contrastive loss makes it prohibitive to use. Furthermore, labeled target data is not easily available in medical imaging, and obtaining new samples is not economical. As a result, in this work, we tackle a more challenging UDA task when there are only a few (fewshot) or a single (oneshot) image available from the target domain. We apply a style transfer module to mitigate the scarcity of target samples. Then, to align the source and target features and tackle the memory issue of the traditional contrastive loss, we propose the centroid-based contrastive learning (CCL) and a centroid norm regularizer (CNR) to optimize the contrastive pairs in both direction and magnitude. In addition, we propose multi-partition centroid contrastive learning (MPCCL) to further reduce the variance in the target features. Fewshot evaluation on MS-CMRSeg dataset demonstrates that ConFUDA improves the segmentation performance by 0.34 of the Dice score on the target domain compared with the baseline, and 0.31 Dice score improvement in a more rigorous oneshot setting.

Unsupervised domain adaptation (UDA) methods intend to reduce the gap between source and target domains by using unlabeled target domain and labeled source domain data, however, in the medical domain, target domain data may not always be easily available, and acquiring new samples is generally time-consuming. This restricts the development of UDA methods for new domains. In this paper, we explore the potential of UDA in a more challenging while realistic scenario where only one unlabeled target patient sample is available. We call it Few-shot Unsupervised Domain adaptation (FUDA). We first generate target-style images from source images and explore diverse target styles from a single target patient with Random Adaptive Instance Normalization (RAIN). Then, a segmentation network is trained in a supervised manner with the generated target images. Our experiments demonstrate that FUDA improves the segmentation performance by 0.33 of Dice score on the target domain compared with the baseline, and it also gives 0.28 of Dice score improvement in a more rigorous one-shot setting. Our code is available at \url{https://github.com/MingxuanGu/Few-shot-UDA}., Comment: Accepted t0 BVM2022

Image registration is a fundamental medical image analysis task, and a wide variety of approaches have been proposed. However, only a few studies have comprehensively compared medical image registration approaches on a wide range of clinically relevant tasks. This limits the development of registration methods, the adoption of research advances into practice, and a fair benchmark across competing approaches. The Learn2Reg challenge addresses these limitations by providing a multi-task medical image registration data set for comprehensive characterisation of deformable registration algorithms. A continuous evaluation will be possible at https://learn2reg.grand-challenge.org. Learn2Reg covers a wide range of anatomies (brain, abdomen, and thorax), modalities (ultrasound, CT, MR), availability of annotations, as well as intra- and inter-patient registration evaluation. We established an easily accessible framework for training and validation of 3D registration methods, which enabled the compilation of results of over 65 individual method submissions from more than 20 unique teams. We used a complementary set of metrics, including robustness, accuracy, plausibility, and runtime, enabling unique insight into the current state-of-the-art of medical image registration. This paper describes datasets, tasks, evaluation methods and results of the challenge, as well as results of further analysis of transferability to new datasets, the importance of label supervision, and resulting bias. While no single approach worked best across all tasks, many methodological aspects could be identified that push the performance of medical image registration to new state-of-the-art performance. Furthermore, we demystified the common belief that conventional registration methods have to be much slower than deep-learning-based methods.

Deep learning models are sensitive to domain shift phenomena. A model trained on images from one domain cannot generalise well when tested on images from a different domain, despite capturing similar anatomical structures. It is mainly because the data distribution between the two domains is different. Moreover, creating annotation for every new modality is a tedious and time-consuming task, which also suffers from high inter- and intra- observer variability. Unsupervised domain adaptation (UDA) methods intend to reduce the gap between source and target domains by leveraging source domain labelled data to generate labels for the target domain. However, current state-of-the-art (SOTA) UDA methods demonstrate degraded performance when there is insufficient data in source and target domains. In this paper, we present a novel UDA method for multi-modal cardiac image segmentation. The proposed method is based on adversarial learning and adapts network features between source and target domain in different spaces. The paper introduces an end-to-end framework that integrates: a) entropy minimisation, b) output feature space alignment and c) a novel point-cloud shape adaptation based on the latent features learned by the segmentation model. We validated our method on two cardiac datasets by adapting from the annotated source domain, bSSFP-MRI (balanced Steady-State Free Procession-MRI), to the unannotated target domain, LGE-MRI (Late-gadolinium enhance-MRI), for the multi-sequence dataset; and from MRI (source) to CT (target) for the cross-modality dataset. The results highlighted that by enforcing adversarial learning in different parts of the network, the proposed method delivered promising performance, compared to other SOTA methods., Comment: Accepted for publication in IEEE Transactions on Medical Imaging (IEEE TMI)

Quantitative assessment of cardiac left ventricle (LV) morphology is essential to assess cardiac function and improve the diagnosis of different cardiovascular diseases. In current clinical practice, LV quantification depends on the measurement of myocardial shape indices, which is usually achieved by manual contouring of the endo- and epicardial. However, this process subjected to inter and intra-observer variability, and it is a time-consuming and tedious task. In this paper, we propose a spatio-temporal multi-task learning approach to obtain a complete set of measurements quantifying cardiac LV morphology, regional-wall thickness (RWT), and additionally detecting the cardiac phase cycle (systole and diastole) for a given 3D Cine-magnetic resonance (MR) image sequence. We first segment cardiac LVs using an encoder-decoder network and then introduce a multitask framework to regress 11 LV indices and classify the cardiac phase, as parallel tasks during model optimization. The proposed deep learning model is based on the 3D spatio-temporal convolutions, which extract spatial and temporal features from MR images. We demonstrate the efficacy of the proposed method using cine-MR sequences of 145 subjects and comparing the performance with other state-of-the-art quantification methods. The proposed method obtained high prediction accuracy, with an average mean absolute error (MAE) of 129 $mm^2$, 1.23 $mm$, 1.76 $mm$, Pearson correlation coefficient (PCC) of 96.4%, 87.2%, and 97.5% for LV and myocardium (Myo) cavity regions, 6 RWTs, 3 LV dimensions, and an error rate of 9.0\% for phase classification. The experimental results highlight the robustness of the proposed method, despite varying degrees of cardiac morphology, image appearance, and low contrast in the cardiac MR sequences., Comment: Accepted at IEEE Journal of Biomedical and Health Informatics (IEEE-JBHI)

Accurate computing, analysis and modeling of the ventricles and myocardium from medical images are important, especially in the diagnosis and treatment management for patients suffering from myocardial infarction (MI). Late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) provides an important protocol to visualize MI. However, automated segmentation of LGE CMR is still challenging, due to the indistinguishable boundaries, heterogeneous intensity distribution and complex enhancement patterns of pathological myocardium from LGE CMR. Furthermore, compared with the other sequences LGE CMR images with gold standard labels are particularly limited, which represents another obstacle for developing novel algorithms for automatic segmentation of LGE CMR. This paper presents the selective results from the Multi-Sequence Cardiac MR (MS-CMR) Segmentation challenge, in conjunction with MICCAI 2019. The challenge offered a data set of paired MS-CMR images, including auxiliary CMR sequences as well as LGE CMR, from 45 patients who underwent cardiomyopathy. It was aimed to develop new algorithms, as well as benchmark existing ones for LGE CMR segmentation and compare them objectively. In addition, the paired MS-CMR images could enable algorithms to combine the complementary information from the other sequences for the segmentation of LGE CMR. Nine representative works were selected for evaluation and comparisons, among which three methods are unsupervised methods and the other six are supervised. The results showed that the average performance of the nine methods was comparable to the inter-observer variations. The success of these methods was mainly attributed to the inclusion of the auxiliary sequences from the MS-CMR images, which provide important label information for the training of deep neural networks., Comment: 14 pages

Segmentation of cardiac images, particularly late gadolinium-enhanced magnetic resonance imaging (LGE-MRI) widely used for visualizing diseased cardiac structures, is a crucial first step for clinical diagnosis and treatment. However, direct segmentation of LGE-MRIs is challenging due to its attenuated contrast. Since most clinical studies have relied on manual and labor-intensive approaches, automatic methods are of high interest, particularly optimized machine learning approaches. To address this, we organized the "2018 Left Atrium Segmentation Challenge" using 154 3D LGE-MRIs, currently the world's largest cardiac LGE-MRI dataset, and associated labels of the left atrium segmented by three medical experts, ultimately attracting the participation of 27 international teams. In this paper, extensive analysis of the submitted algorithms using technical and biological metrics was performed by undergoing subgroup analysis and conducting hyper-parameter analysis, offering an overall picture of the major design choices of convolutional neural networks (CNNs) and practical considerations for achieving state-of-the-art left atrium segmentation. Results show the top method achieved a dice score of 93.2% and a mean surface to a surface distance of 0.7 mm, significantly outperforming prior state-of-the-art. Particularly, our analysis demonstrated that double, sequentially used CNNs, in which a first CNN is used for automatic region-of-interest localization and a subsequent CNN is used for refined regional segmentation, achieved far superior results than traditional methods and pipelines containing single CNNs. This large-scale benchmarking study makes a significant step towards much-improved segmentation methods for cardiac LGE-MRIs, and will serve as an important benchmark for evaluating and comparing the future works in the field.

Cardiovascular diseases are the most common cause of mortality worldwide. Detection of atrial fibrillation (AF) in the asymptomatic stage can help prevent strokes. It also improves clinical decision making through the delivery of suitable treatment such as, anticoagulant therapy, in a timely manner. The clinical significance of such early detection of AF in electrocardiogram (ECG) signals has inspired numerous studies in recent years, of which many aim to solve this task by leveraging machine learning algorithms. ECG datasets containing AF samples, however, usually suffer from severe class imbalance, which if unaccounted for, affects the performance of classification algorithms. Data augmentation is a popular solution to tackle this problem. In this study, we investigate the impact of various data augmentation algorithms, e.g., oversampling, Gaussian Mixture Models (GMMs) and Generative Adversarial Networks (GANs), on solving the class imbalance problem. These algorithms are quantitatively and qualitatively evaluated, compared and discussed in detail. The results show that deep learning-based AF signal classification methods benefit more from data augmentation using GANs and GMMs, than oversampling. Furthermore, the GAN results in circa $3\%$ better AF classification accuracy in average while performing comparably to the GMM in terms of f1-score.

Chronic obstructive pulmonary disease (COPD) is a lung disease that is not fully reversible and one of the leading causes of morbidity and mortality in the world. Early detection and diagnosis of COPD can increase the survival rate and reduce the risk of COPD progression in patients. Currently, the primary examination tool to diagnose COPD is spirometry. However, computed tomography (CT) is used for detecting symptoms and sub-type classification of COPD. Using different imaging modalities is a difficult and tedious task even for physicians and is subjective to inter-and intra-observer variations. Hence, developing meth-ods that can automatically classify COPD versus healthy patients is of great interest. In this paper, we propose a 3D deep learning approach to classify COPD and emphysema using volume-wise annotations only. We also demonstrate the impact of transfer learning on the classification of emphysema using knowledge transfer from a pre-trained COPD classification model.

Mammography is using low-energy X-rays to screen the human breast and is utilized by radiologists to detect breast cancer. Typically radiologists require a mammogram with impeccable image quality for an accurate diagnosis. In this study, we propose a deep learning method based on Convolutional Neural Networks (CNNs) for mammogram denoising to improve the image quality. We first enhance the noise level and employ Anscombe Transformation (AT) to transform Poisson noise to white Gaussian noise. With this data augmentation, a deep residual network is trained to learn the noise map of the noisy images. We show, that the proposed method can remove not only simulated but also real noise. Furthermore, we also compare our results with state-of-the-art denoising methods, such as BM3D and DNCNN. In an early investigation, we achieved qualitatively better mammogram denoising results., Comment: Accepted at BVM 2020

Left ventricle segmentation and morphological assessment are essential for improving diagnosis and our understanding of cardiomyopathy, which in turn is imperative for reducing risk of myocardial infarctions in patients. Convolutional neural network (CNN) based methods for cardiac magnetic resonance (CMR) image segmentation rely on supervision with pixel-level annotations, and may not generalize well to images from a different domain. These methods are typically sensitive to variations in imaging protocols and data acquisition. Since annotating multi-sequence CMR images is tedious and subject to inter- and intra-observer variations, developing methods that can automatically adapt from one domain to the target domain is of great interest. In this paper, we propose an approach for domain adaptation in multi-sequence CMR segmentation task using transfer learning that combines multi-source image information. We first train an encoder-decoder CNN on T2-weighted and balanced-Steady State Free Precession (bSSFP) MR images with pixel-level annotation and fine-tune the same network with a limited number of Late Gadolinium Enhanced-MR (LGE-MR) subjects, to adapt the domain features. The domain-adapted network was trained with just four LGE-MR training samples and obtained an average Dice score of $\sim$85.0\% on the test set comprises of 40 LGE-MR subjects. The proposed method significantly outperformed a network without adaptation trained from scratch on the same set of LGE-MR training data., Comment: Accepted at STACOM-MICCAI 2019

Automatic segmentation of organs-at-risk (OAR) in computed tomography (CT) is an essential part of planning effective treatment strategies to combat lung and esophageal cancer. Accurate segmentation of organs surrounding tumours helps account for the variation in position and morphology inherent across patients, thereby facilitating adaptive and computer-assisted radiotherapy. Although manual delineation of OARs is still highly prevalent, it is prone to errors due to complex variations in the shape and position of organs across patients, and low soft tissue contrast between neighbouring organs in CT images. Recently, deep convolutional neural networks (CNNs) have gained tremendous traction and achieved state-of-the-art results in medical image segmentation. In this paper, we propose a deep learning framework to segment OARs in thoracic CT images, specifically for the: heart, esophagus, trachea and aorta. Our approach employs dilated convolutions and aggregated residual connections in the bottleneck of a U-Net styled network, which incorporates global context and dense information. Our method achieved an overall Dice score of 91.57% on 20 unseen test samples from the ISBI 2019 SegTHOR challenge., Comment: ISBI-SegTHOR 2019 Challenge

Tissue loss in the hippocampi has been heavily correlated with the progression of Alzheimer's Disease (AD). The shape and structure of the hippocampus are important factors in terms of early AD diagnosis and prognosis by clinicians. However, manual segmentation of such subcortical structures in MR studies is a challenging and subjective task. In this paper, we investigate variants of the well known 3D U-Net, a type of convolution neural network (CNN) for semantic segmentation tasks. We propose an alternative form of the 3D U-Net, which uses dilated convolutions and deep supervision to incorporate multi-scale information into the model. The proposed method is evaluated on the task of hippocampus head and body segmentation in an MRI dataset, provided as part of the MICCAI 2018 segmentation decathlon challenge. The experimental results show that our approach outperforms other conventional methods in terms of different segmentation accuracy metrics., Comment: BVM 2019 conference paper

Early detection and segmentation of skin lesions is crucial for timely diagnosis and treatment, necessary to improve the survival rate of patients. However, manual delineation is time consuming and subject to intra- and inter-observer variations among dermatologists. This underlines the need for an accurate and automatic approach to skin lesion segmentation. To tackle this issue, we propose a multi-task convolutional neural network (CNN) based, joint detection and segmentation framework, designed to initially localize the lesion and subsequently, segment it. A `Faster region-based convolutional neural network' (Faster-RCNN) which comprises a region proposal network (RPN), is used to generate bounding boxes/region proposals, for lesion localization in each image. The proposed regions are subsequently refined using a softmax classifier and a bounding-box regressor. The refined bounding boxes are finally cropped and segmented using `SkinNet', a modified version of U-Net. We trained and evaluated the performance of our network, using the ISBI 2017 challenge and the PH2 datasets, and compared it with the state-of-the-art, using the official test data released as part of the challenge for the former. Our approach outperformed others in terms of Dice coefficients ($>0.93$), Jaccard index ($>0.88$), accuracy ($>0.96$) and sensitivity ($>0.95$), across five-fold cross validation experiments., Comment: Accepted in ISIC-MICCAI 2018 Workshop

Segmentation of the left atrial chamber and assessing its morphology, are essential for improving our understanding of atrial fibrillation, the most common type of cardiac arrhythmia. Automation of this process in 3D gadolinium enhanced-MRI (GE-MRI) data is desirable, as manual delineation is time-consuming, challenging and observer-dependent. Recently, deep convolutional neural networks (CNNs) have gained tremendous traction and achieved state-of-the-art results in medical image segmentation. However, it is difficult to incorporate local and global information without using contracting (pooling) layers, which in turn reduces segmentation accuracy for smaller structures. In this paper, we propose a 3D CNN for volumetric segmentation of the left atrial chamber in LGE-MRI. Our network is based on the well known U-Net architecture. We employ a 3D fully convolutional network, with dilated convolutions in the lowest level of the network, and residual connections between encoder blocks to incorporate local and global knowledge. The results show that including global context through the use of dilated convolutions, helps in domain adaptation, and the overall segmentation accuracy is improved in comparison to a 3D U-Net., Comment: Accepted in SATCOM-MICCAI 2018 Workshop

There has been a steady increase in the incidence of skin cancer worldwide, with a high rate of mortality. Early detection and segmentation of skin lesions are crucial for timely diagnosis and treatment, necessary to improve the survival rate of patients. However, skin lesion segmentation is a challenging task due to the low contrast of lesions and their high similarity in terms of appearance, to healthy tissue. This underlines the need for an accurate and automatic approach for skin lesion segmentation. To tackle this issue, we propose a convolutional neural network (CNN) called SkinNet. The proposed CNN is a modified version of U-Net. We compared the performance of our approach with other state-of-the-art techniques, using the ISBI 2017 challenge dataset. Our approach outperformed the others in terms of the Dice coefficient, Jaccard index and sensitivity, evaluated on the held-out challenge test data set, across 5-fold cross validation experiments. SkinNet achieved an average value of 85.10, 76.67 and 93.0%, for the DC, JI, and SE, respectively., Comment: 2 pages, submitted to NSS/MIC 2018

Breast cancer is one of the leading causes of mortality in women. Early detection and treatment are imperative for improving survival rates, which have steadily increased in recent years as a result of more sophisticated computer-aided-diagnosis (CAD) systems. A critical component of breast cancer diagnosis relies on histopathology, a laborious and highly subjective process. Consequently, CAD systems are essential to reduce inter-rater variability and supplement the analyses conducted by specialists. In this paper, a transfer-learning based approach is proposed, for the task of breast histology image classification into four tissue sub-types, namely, normal, benign, \textit{in situ} carcinoma and invasive carcinoma. The histology images, provided as part of the BACH 2018 grand challenge, were first normalized to correct for color variations resulting from inconsistencies during slide preparation. Subsequently, image patches were extracted and used to fine-tune Google`s Inception-V3 and ResNet50 convolutional neural networks (CNNs), both pre-trained on the ImageNet database, enabling them to learn domain-specific features, necessary to classify the histology images. The ResNet50 network (based on residual learning) achieved a test classification accuracy of 97.50% for four classes, outperforming the Inception-V3 network which achieved an accuracy of 91.25%., Comment: 8 pages, Submitted to 15th International Conference on Image Analysis and Recognition (ICAIR 2018)

Accurate segmentation of breast lesions is a crucial step in evaluating the characteristics of tumors. However, this is a challenging task, since breast lesions have sophisticated shape, topological structure, and variation in the intensity distribution. In this paper, we evaluated the performance of three unsupervised algorithms for the task of breast Magnetic Resonance (MRI) lesion segmentation, namely, Gaussian Mixture Model clustering, K-means clustering and a marker-controlled Watershed transformation based method. All methods were applied on breast MRI slices following selection of regions of interest (ROIs) by an expert radiologist and evaluated on 106 subjects' images, which include 59 malignant and 47 benign lesions. Segmentation accuracy was evaluated by comparing our results with ground truth masks, using the Dice similarity coefficient (DSC), Jaccard index (JI), Hausdorff distance and precision-recall metrics. The results indicate that the marker-controlled Watershed transformation outperformed all other algorithms investigated., Comment: 6 pages, submitted to Bildverarbeitung in der Medizin 2018

Old master drawings were mostly created step by step in several layers using different materials. To art historians and restorers, examination of these layers brings various insights into the artistic work process and helps to answer questions about the object, its attribution and its authenticity. However, these layers typically overlap and are oftentimes difficult to differentiate with the unaided eye. For example, a common layer combination is red chalk under ink. In this work, we propose an image processing pipeline that operates on hyperspectral images to separate such layers. Using this pipeline, we show that hyperspectral images enable better layer separation than RGB images, and that spectral focus stacking aids the layer separation. In particular, we propose to use two descriptors in hyperspectral historical document analysis, namely hyper-hue and extended multi-attribute profile (EMAP). Our comparative results with other features underline the efficacy of the three proposed improvements.

Magnetic resonance imaging (MRI) is an effective imaging modality for identifying and localizing breast lesions in women. Accurate and precise lesion segmentation using a computer-aided-diagnosis (CAD) system, is a crucial step in evaluating tumor volume and in the quantification of tumor characteristics. However, this is a challenging task, since breast lesions have sophisticated shape, topological structure, and high variance in their intensity distribution across patients. In this paper, we propose a novel marker-controlled watershed transformation-based approach, which uses the brightest pixels in a region of interest (determined by experts) as markers to overcome this challenge, and accurately segment lesions in breast MRI. The proposed approach was evaluated on 106 lesions, which includes 64 malignant and 42 benign cases. Segmentation results were quantified by comparison with ground truth labels, using the Dice similarity coefficient (DSC) and Jaccard index (JI) metrics. The proposed method achieved an average Dice coefficient of 0.7808$\pm$0.1729 and Jaccard index of 0.6704$\pm$0.2167. These results illustrate that the proposed method shows promise for future work related to the segmentation and classification of benign and malignant breast lesions.