  Accurate and fast extraction of lung volumes from computed tomography (CT)
scans remains in a great demand in the clinical environment because the
available methods fail to provide a generic solution due to wide anatomical
variations of lungs and existence of pathologies. Manual annotation, current
gold standard, is time consuming and often subject to human bias. On the other
hand, current state-of-the-art fully automated lung segmentation methods fail
to make their way into the clinical practice due to their inability to
efficiently incorporate human input for handling misclassifications and praxis.
This paper presents a lung annotation tool for CT images that is interactive,
efficient, and robust. The proposed annotation tool produces an "as accurate as
possible" initial annotation based on the fuzzy-connectedness image
segmentation, followed by efficient manual fixation of the initial extraction
if deemed necessary by the practitioner. To provide maximum flexibility to the
users, our annotation tool is supported in three major operating systems
(Windows, Linux, and the Mac OS X). The quantitative results comparing our free
software with commercially available lung segmentation tools show higher degree
of consistency and precision of our software with a considerable potential to
enhance the performance of routine clinical tasks.
