Enhancing predictability of IDH mutation status in glioma patients at initial diagnosis: a comparative analysis of radiomics from MRI, [18F]FET PET, and TSPO PET.

PURPOSE: According to the World Health Organization classification for tumors of the central nervous system, mutation status of the isocitrate dehydrogenase (IDH) genes has become a major diagnostic discriminator for gliomas. Therefore, imaging-based prediction of IDH mutation status is of high interest for individual patient management. We compared and evaluated the diagnostic value of radiomics derived from dual positron emission tomography (PET) and magnetic resonance imaging (MRI) data to predict the IDH mutation status non-invasively. METHODS: Eighty-seven glioma patients at initial diagnosis who underwent PET targeting the translocator protein (TSPO) using [18F]GE-180, dynamic amino acid PET using [18F]FET, and T1-/T2-weighted MRI scans were examined. In addition to calculating tumor-to-background ratio (TBR) images for all modalities, parametric images quantifying dynamic [18F]FET PET information were generated. Radiomic features were extracted from TBR and parametric images. The area under the receiver operating characteristic curve (AUC) was employed to assess the performance of logistic regression (LR) classifiers. To report robust estimates, nested cross-validation with five folds and 50 repeats was applied. RESULTS: TBRGE-180 features extracted from TSPO-positive volumes had the highest predictive power among TBR images (AUC 0.88, with age as co-factor 0.94). Dynamic [18F]FET PET reached a similarly high performance (0.94, with age 0.96). The highest LR coefficients in multimodal analyses included TBRGE-180 features, parameters from kinetic and early static [18F]FET PET images, age, and the features from TBRT2 images such as the kurtosis (0.97). CONCLUSION: The findings suggest that incorporating TBRGE-180 features along with kinetic information from dynamic [18F]FET PET, kurtosis from TBRT2, and age can yield very high predictability of IDH mutation status, thus potentially improving early patient management.

Self-attention-based generative adversarial network optimized with color harmony algorithm for brain tumor classification.

This paper proposes a novel approach, BTC-SAGAN-CHA-MRI, for the classification of brain tumors using a SAGAN optimized with a Color Harmony Algorithm. Brain cancer, with its high fatality rate worldwide, especially in the case of brain tumors, necessitates more accurate and efficient classification methods. While existing deep learning approaches for brain tumor classification have been suggested, they often lack precision and require substantial computational time.The proposed method begins by gathering input brain MR images from the BRATS dataset, followed by a pre-processing step using a Mean Curvature Flow-based approach to eliminate noise. The pre-processed images then undergo the Improved Non-Sub sampled Shearlet Transform (INSST) for extracting radiomic features. These features are fed into the SAGAN, which is optimized with a Color Harmony Algorithm to categorize the brain images into different tumor types, including Gliomas, Meningioma, and Pituitary tumors. This innovative approach shows promise in enhancing the precision and efficiency of brain tumor classification, holding potential for improved diagnostic outcomes in the field of medical imaging. The accuracy acquired for the brain tumor identification from the proposed method is 99.29%. The proposed BTC-SAGAN-CHA-MRI technique achieves 18.29%, 14.09% and 7.34% higher accuracy and 67.92%,54.04%, and 59.08% less Computation Time when analyzed to the existing models, like Brain tumor diagnosis utilizing deep learning convolutional neural network with transfer learning approach (BTC-KNN-SVM-MRI); M3BTCNet: multi model brain tumor categorization under metaheuristic deep neural network features optimization (BTC-CNN-DEMFOA-MRI), and efficient method depending upon hierarchical deep learning neural network classifier for brain tumour categorization (BTC-Hie DNN-MRI) respectively.

This paper proposes a novel approach, BTC-SAGAN-CHA-MRI, for the classification of brain tumors using a Self-Attention based Generative Adversarial Network (SAGAN) optimized with a Color Harmony Algorithm. Brain cancer, with its high fatality rate worldwide, especially in the case of brain tumors, necessitates more accurate and efficient classification methods. While existing deep learning approaches for brain tumor classification have been suggested, they often lack precision and require substantial computational time. The proposed method begins by gathering input brain MR images from the BRATS dataset, followed by a pre-processing step using a Mean Curvature Flow-based approach to eliminate noise. The pre-processed images then undergo the Improved Non-Sub sampled Shearlet Transform (INSST) for extracting radiomic features. These features are fed into the SAGAN, which is optimized with a Color Harmony Algorithm to categorize the brain images into different tumor types, including Gliomas, Meningioma, and Pituitary tumors. This innovative approach shows promise in enhancing the precision and efficiency of brain tumor classification, holding potential for improved diagnostic outcomes in the field of medical imaging.

Gradual Self-Training via Confidence and Volume Based Domain Adaptation for Multi Dataset Deep Learning-Based Brain Metastases Detection Using Nonlocal Networks on MRI Images.

BACKGROUND: Research suggests that treatment of multiple brain metastases (BMs) with stereotactic radiosurgery shows improvement when metastases are detected early, providing a case for BM detection capabilities on small lesions. PURPOSE: To demonstrate automatic detection of BM on three MRI datasets using a deep learning-based approach. To improve the performance of the network is iteratively co-trained with datasets from different domains. A systematic approach is proposed to prevent catastrophic forgetting during co-training. STUDY TYPE: Retrospective. POPULATION: A total of 156 patients (105 ground truth and 51 pseudo labels) with 1502 BM (BrainMetShare); 121 patients with 722 BM (local); 400 patients with 447 primary gliomas (BrATS). Training/pseudo labels/validation data were distributed 84/51/21 (BrainMetShare). Training/validation data were split: 121/23 (local) and 375/25 (BrATS). FIELD STRENGTH/SEQUENCE: A 5 T and 3 T/T1 spin-echo postcontrast (T1-gradient echo) (BrainMetShare), 3 T/T1 magnetization prepared rapid acquisition gradient echo postcontrast (T1-MPRAGE) (local), 0.5 T, 1 T, and 1.16 T/T1-weighted-fluid-attenuated inversion recovery (T1-FLAIR) (BrATS). ASSESSMENT: The ground truth was manually segmented by two (BrainMetShare) and four (BrATS) radiologists and manually annotated by one (local) radiologist. Confidence and volume based domain adaptation (CAVEAT) method of co-training the three datasets on a 3D nonlocal convolutional neural network (CNN) architecture was implemented to detect BM. STATISTICAL TESTS: The performance was evaluated using sensitivity and false positive rates per patient (FP/patient) and free receiver operating characteristic (FROC) analysis at seven predefined (1/8, 1/4, 1/2, 1, 2, 4, and 8) FPs per scan. RESULTS: The sensitivity and FP/patient from a held-out set registered 0.811 at 2.952 FP/patient (BrainMetShare), 0.74 at 3.130 (local), and 0.723 at 2.240 (BrATS) using the CAVEAT approach with lesions as small as 1 mm being detected. DATA CONCLUSION: Improved sensitivities at lower FP can be achieved by co-training datasets via the CAVEAT paradigm to address the problem of data sparsity. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY STAGE: 2.

A Comparison of Three Different Deep Learning-Based Models to Predict the MGMT Promoter Methylation Status in Glioblastoma Using Brain MRI.

Glioblastoma (GBM) is the most common primary malignant brain tumor in adults. The standard treatment for GBM consists of surgical resection followed by concurrent chemoradiotherapy and adjuvant temozolomide. O-6-methylguanine-DNA methyltransferase (MGMT) promoter methylation status is an important prognostic biomarker that predicts the response to temozolomide and guides treatment decisions. At present, the only reliable way to determine MGMT promoter methylation status is through the analysis of tumor tissues. Considering the complications of the tissue-based methods, an imaging-based approach is preferred. This study aimed to compare three different deep learning-based approaches for predicting MGMT promoter methylation status. We obtained 576 T2WI with their corresponding tumor masks, and MGMT promoter methylation status from, The Brain Tumor Segmentation (BraTS) 2021 datasets. We developed three different models: voxel-wise, slice-wise, and whole-brain. For voxel-wise classification, methylated and unmethylated MGMT tumor masks were made into 1 and 2 with 0 background, respectively. We converted each T2WI into 32 × 32 × 32 patches. We trained a 3D-Vnet model for tumor segmentation. After inference, we constructed the whole brain volume based on the patch's coordinates. The final prediction of MGMT methylation status was made by majority voting between the predicted voxel values of the biggest connected component. For slice-wise classification, we trained an object detection model for tumor detection and MGMT methylation status prediction, then for final prediction, we used majority voting. For the whole-brain approach, we trained a 3D Densenet121 for prediction. Whole-brain, slice-wise, and voxel-wise, accuracy was 65.42% (SD 3.97%), 61.37% (SD 1.48%), and 56.84% (SD 4.38%), respectively.

Three-Phase Automatic Brain Tumor Diagnosis System Using Patches Based Updated Run Length Region Growing Technique.

Manually finding and segmenting brain tumor is a tedious process in MR brain images due to the unpredictable appearance of tissues with a different pattern, contour, mass, and positions. The proposed work has three phases automatic tumor diagnosis system for tumorous slice detection, segmentation, and visualization from MRI human head volumes. The proposed method has an automatic classification followed by segmentation and is called as patch-based updated run length region growing technique (PR2G). In the first phase, classification is done through training and testing process using SVM classifier with 8 × 8 patches. Three optimal features are chosen using infinite feature selection (IFS) method. The purpose of the first phase is to automatically cluster the input MRI image into a normal or tumorous slice and localize the tumor. The second phase aims to segment the tumor in abnormal tumorous slices identified by the first phase using run length region growing technique. Finally, the third phase contains a post metric evaluation like 3D tumor volume construction and estimation from actual and segmented tumor volume using Carelieri's estimator. Classification accuracy is measured using sensitivity, specificity, accuracy, and error rates also calculated using false alarm (FA) and missed alarm (MA). Segmentation accuracy is calculated using Dice similarity, positive predictive value (PPV), sensitivity, and accuracy. Datasets used for this experiment are collected from whole brain atlas (WBA) and BraTS repositories. Experimental results show that the PR2G achieves 97% of classification accuracy and 80% of Dice segmentation accuracy.

Auto-segmentation of Adult-Type Diffuse Gliomas: Comparison of Transfer Learning-Based Convolutional Neural Network Model vs. Radiologists.

Segmentation of glioma is crucial for quantitative brain tumor assessment, to guide therapeutic research and clinical management, but very time-consuming. Fully automated tools for the segmentation of multi-sequence MRI are needed. We developed and pretrained a deep learning (DL) model using publicly available datasets A (n = 210) and B (n = 369) containing FLAIR, T2WI, and contrast-enhanced (CE)-T1WI. This was then fine-tuned with our institutional dataset (n = 197) containing ADC, T2WI, and CE-T1WI, manually annotated by radiologists, and split into training (n = 100) and testing (n = 97) sets. The Dice similarity coefficient (DSC) was used to compare model outputs and manual labels. A third independent radiologist assessed segmentation quality on a semi-quantitative 5-scale score. Differences in DSC between new and recurrent gliomas, and between uni or multifocal gliomas were analyzed using the Mann-Whitney test. Semi-quantitative analyses were compared using the chi-square test. We found that there was good agreement between segmentations from the fine-tuned DL model and ground truth manual segmentations (median DSC: 0.729, std-dev: 0.134). DSC was higher for newly diagnosed (0.807) than recurrent (0.698) (p < 0.001), and higher for unifocal (0.747) than multi-focal (0.613) cases (p = 0.001). Semi-quantitative scores of DL and manual segmentation were not significantly different (mean: 3.567 vs. 3.639; 93.8% vs. 97.9% scoring ≥ 3, p = 0.107). In conclusion, the proposed transfer learning DL performed similarly to human radiologists in glioma segmentation on both structural and ADC sequences. Further improvement in segmenting challenging postoperative and multifocal glioma cases is needed.

The Brain Tumor Segmentation (BraTS) Challenge 2023: Focus on Pediatrics (CBTN-CONNECT-DIPGR-ASNR-MICCAI BraTS-PEDs).

Pediatric tumors of the central nervous system are the most common cause of cancer-related death in children. The five-year survival rate for high-grade gliomas in children is less than 20%. Due to their rarity, the diagnosis of these entities is often delayed, their treatment is mainly based on historic treatment concepts, and clinical trials require multi-institutional collaborations. The MICCAI Brain Tumor Segmentation (BraTS) Challenge is a landmark community benchmark event with a successful history of 12 years of resource creation for the segmentation and analysis of adult glioma. Here we present the CBTN-CONNECT-DIPGR-ASNR-MICCAI BraTS-PEDs 2023 challenge, which represents the first BraTS challenge focused on pediatric brain tumors with data acquired across multiple international consortia dedicated to pediatric neuro-oncology and clinical trials. The BraTS-PEDs 2023 challenge focuses on benchmarking the development of volumentric segmentation algorithms for pediatric brain glioma through standardized quantitative performance evaluation metrics utilized across the BraTS 2023 cluster of challenges. Models gaining knowledge from the BraTS-PEDs multi-parametric structural MRI (mpMRI) training data will be evaluated on separate validation and unseen test mpMRI dataof high-grade pediatric glioma. The CBTN-CONNECT-DIPGR-ASNR-MICCAI BraTS-PEDs 2023 challenge brings together clinicians and AI/imaging scientists to lead to faster development of automated segmentation techniques that could benefit clinical trials, and ultimately the care of children with brain tumors.

mResU-Net: multi-scale residual U-Net-based brain tumor segmentation from multimodal MRI.

Brain tumor segmentation is an important direction in medical image processing, and its main goal is to accurately mark the tumor part in brain MRI. This study proposes a brand new end-to-end model for brain tumor segmentation, which is a multi-scale deep residual convolutional neural network called mResU-Net. The semantic gap between the encoder and decoder is bridged by using skip connections in the U-Net structure. The residual structure is used to alleviate the vanishing gradient problem during training and ensure sufficient information in deep networks. On this basis, multi-scale convolution kernels are used to improve the segmentation accuracy of targets of different sizes. At the same time, we also integrate channel attention modules into the network to improve its accuracy. The proposed model has an average dice score of 0.9289, 0.9277, and 0.8965 for tumor core (TC), whole tumor (WT), and enhanced tumor (ET) on the BraTS 2021 dataset, respectively. Comparing the segmentation results of this method with existing techniques shows that mResU-Net can significantly improve the segmentation performance of brain tumor subregions.

Modality redundancy for MRI-based glioblastoma segmentation.

PURPOSE: Automated glioblastoma segmentation from magnetic resonance imaging is generally performed on a four-modality input, including T1, contrast T1, T2 and FLAIR. We hypothesize that information redundancy is present within these image combinations, which can possibly reduce a model's performance. Moreover, for clinical applications, the risk of encountering missing data rises as the number of required input modalities increases. Therefore, this study aimed to explore the relevance and influence of the different modalities used for MRI-based glioblastoma segmentation. METHODS: After the training of multiple segmentation models based on nnU-Net and SwinUNETR architectures, differing only in their amount and combinations of input modalities, each model was evaluated with regard to segmentation accuracy and epistemic uncertainty. RESULTS: Results show that T1CE-based segmentation (for enhanced tumor and tumor core) and T1CE-FLAIR-based segmentation (for whole tumor and overall segmentation) can reach segmentation accuracies comparable to the full-input version. Notably, the highest segmentation accuracy for nnU-Net was found for a three-input configuration of T1CE-FLAIR-T1, suggesting the confounding effect of redundant input modalities. The SwinUNETR architecture appears to suffer less from this, where said three-input and the full-input model yielded statistically equal results. CONCLUSION: The T1CE-FLAIR-based model can therefore be considered as a minimal-input alternative to the full-input configuration. Addition of modalities beyond this does not statistically improve and can even deteriorate accuracy, but does lower the segmentation uncertainty.

Federated brain tumor segmentation: An extensive benchmark.

Recently, federated learning has raised increasing interest in the medical image analysis field due to its ability to aggregate multi-center data with privacy-preserving properties. A large amount of federated training schemes have been published, which we categorize into global (one final model), personalized (one model per institution) or hybrid (one model per cluster of institutions) methods. However, their applicability on the recently published Federated Brain Tumor Segmentation 2022 dataset has not been explored yet. We propose an extensive benchmark of federated learning algorithms from all three classes on this task. While standard FedAvg already performs very well, we show that some methods from each category can bring a slight performance improvement and potentially limit the final model(s) bias toward the predominant data distribution of the federation. Moreover, we provide a deeper understanding of the behavior of federated learning on this task through alternative ways of distributing the pooled dataset among institutions, namely an Independent and Identical Distributed (IID) setup, and a limited data setup. Our code is available at (https://github.com/MatthisManthe/Benchmark_FeTS2022).

The Brain Tumor Segmentation (BraTS-METS) Challenge 2023: Brain Metastasis Segmentation on Pre-treatment MRI.

Clinical monitoring of metastatic disease to the brain can be a laborious and timeconsuming process, especially in cases involving multiple metastases when the assessment is performed manually. The Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) guideline, which utilizes the unidimensional longest diameter, is commonly used in clinical and research settings to evaluate response to therapy in patients with brain metastases. However, accurate volumetric assessment of the lesion and surrounding peri-lesional edema holds significant importance in clinical decision-making and can greatly enhance outcome prediction. The unique challenge in performing segmentations of brain metastases lies in their common occurrence as small lesions. Detection and segmentation of lesions that are smaller than 10 mm in size has not demonstrated high accuracy in prior publications. The brain metastases challenge sets itself apart from previously conducted MICCAI challenges on glioma segmentation due to the significant variability in lesion size. Unlike gliomas, which tend to be larger on presentation scans, brain metastases exhibit a wide range of sizes and tend to include small lesions. We hope that the BraTS-METS dataset and challenge will advance the field of automated brain metastasis detection and segmentation.

A review on brain tumor segmentation based on deep learning methods with federated learning techniques.

Brain tumors have become a severe medical complication in recent years due to their high fatality rate. Radiologists segment the tumor manually, which is time-consuming, error-prone, and expensive. In recent years, automated segmentation based on deep learning has demonstrated promising results in solving computer vision problems such as image classification and segmentation. Brain tumor segmentation has recently become a prevalent task in medical imaging to determine the tumor location, size, and shape using automated methods. Many researchers have worked on various machine and deep learning approaches to determine the most optimal solution using the convolutional methodology. In this review paper, we discuss the most effective segmentation techniques based on the datasets that are widely used and publicly available. We also proposed a survey of federated learning methodologies to enhance global segmentation performance and ensure privacy. A comprehensive literature review is suggested after studying more than 100 papers to generalize the most recent techniques in segmentation and multi-modality information. Finally, we concentrated on unsolved problems in brain tumor segmentation and a client-based federated model training strategy. Based on this review, future researchers will understand the optimal solution path to solve these issues.

The Brain Tumor Segmentation (BraTS) Challenge 2023: Brain MR Image Synthesis for Tumor Segmentation (BraSyn).

Automated brain tumor segmentation methods have become well-established and reached performance levels offering clear clinical utility. These methods typically rely on four input magnetic resonance imaging (MRI) modalities: T1-weighted images with and without contrast enhancement, T2-weighted images, and FLAIR images. However, some sequences are often missing in clinical practice due to time constraints or image artifacts, such as patient motion. Consequently, the ability to substitute missing modalities and gain segmentation performance is highly desirable and necessary for the broader adoption of these algorithms in the clinical routine. In this work, we present the establishment of the Brain MR Image Synthesis Benchmark (BraSyn) in conjunction with the Medical Image Computing and Computer-Assisted Intervention (MICCAI) 2023. The primary objective of this challenge is to evaluate image synthesis methods that can realistically generate missing MRI modalities when multiple available images are provided. The ultimate aim is to facilitate automated brain tumor segmentation pipelines. The image dataset used in the benchmark is diverse and multi-modal, created through collaboration with various hospitals and research institutions.

Bridged-U-Net-ASPP-EVO and Deep Learning Optimization for Brain Tumor Segmentation.

Brain tumor segmentation from Magnetic Resonance Images (MRI) is considered a big challenge due to the complexity of brain tumor tissues, and segmenting these tissues from the healthy tissues is an even more tedious challenge when manual segmentation is undertaken by radiologists. In this paper, we have presented an experimental approach to emphasize the impact and effectiveness of deep learning elements like optimizers and loss functions towards a deep learning optimal solution for brain tumor segmentation. We evaluated our performance results on the most popular brain tumor datasets (MICCAI BraTS 2020 and RSNA-ASNR-MICCAI BraTS 2021). Furthermore, a new Bridged U-Net-ASPP-EVO was introduced that exploits Atrous Spatial Pyramid Pooling to enhance capturing multi-scale information to help in segmenting different tumor sizes, Evolving Normalization layers, squeeze and excitation residual blocks, and the max-average pooling for down sampling. Two variants of this architecture were constructed (Bridged U-Net_ASPP_EVO v1 and Bridged U-Net_ASPP_EVO v2). The best results were achieved using these two models when compared with other state-of-the-art models; we have achieved average segmentation dice scores of 0.84, 0.85, and 0.91 from variant1, and 0.83, 0.86, and 0.92 from v2 for the Enhanced Tumor (ET), Tumor Core (TC), and Whole Tumor (WT) tumor sub-regions, respectively, in the BraTS 2021validation dataset.

The Brain Tumor Segmentation (BraTS) Challenge 2023: Glioma Segmentation in Sub-Saharan Africa Patient Population (BraTS-Africa).

Gliomas are the most common type of primary brain tumors. Although gliomas are relatively rare, they are among the deadliest types of cancer, with a survival rate of less than 2 years after diagnosis. Gliomas are challenging to diagnose, hard to treat and inherently resistant to conventional therapy. Years of extensive research to improve diagnosis and treatment of gliomas have decreased mortality rates across the Global North, while chances of survival among individuals in low- and middle-income countries (LMICs) remain unchanged and are significantly worse in Sub-Saharan Africa (SSA) populations. Long-term survival with glioma is associated with the identification of appropriate pathological features on brain MRI and confirmation by histopathology. Since 2012, the Brain Tumor Segmentation (BraTS) Challenge have evaluated state-of-the-art machine learning methods to detect, characterize, and classify gliomas. However, it is unclear if the state-of-the-art methods can be widely implemented in SSA given the extensive use of lower-quality MRI technology, which produces poor image contrast and resolution and more importantly, the propensity for late presentation of disease at advanced stages as well as the unique characteristics of gliomas in SSA (i.e., suspected higher rates of gliomatosis cerebri). Thus, the BraTS-Africa Challenge provides a unique opportunity to include brain MRI glioma cases from SSA in global efforts through the BraTS Challenge to develop and evaluate computer-aided-diagnostic (CAD) methods for the detection and characterization of glioma in resource-limited settings, where the potential for CAD tools to transform healthcare are more likely.

An attention 3DUNET and visual geometry group-19 based deep neural network for brain tumor segmentation and classification from MRI.

There has been an abrupt increase in brain tumor (BT) related medical cases during the past ten years. The tenth most typical type of tumor affecting millions of people is the BT. The cure rate can, however, rise if it is found early. When evaluating BT diagnosis and treatment options, MRI is a crucial tool. However, segmenting the tumors from magnetic resonance (MR) images is complex. The advancement of deep learning (DL) has led to the development of numerous automatic segmentation and classification approaches. However, most need improvement since they are limited to 2D images. So, this article proposes a novel and optimal DL system for segmenting and classifying the BTs from 3D brain MR images. Preprocessing, segmentation, feature extraction, feature selection, and tumor classification are the main phases of the proposed work. Preprocessing, such as noise removal, is performed on the collected brain MR images using bilateral filtering. The tumor segmentation uses spatial and channel attention-based three-dimensional u-shaped network (SC3DUNet) to segment the tumor lesions from the preprocessed data. After that, the feature extraction is done based on dilated convolution-based visual geometry group-19 (DCVGG-19), making the classification task more manageable. The optimal features are selected from the extracted feature sets using diagonal linear uniform and tangent flight included butterfly optimization algorithm. Finally, the proposed system applies an optimal hyperparameters-based deep neural network to classify the tumor classes. The experiments conducted on the BraTS2020 dataset show that the suggested method can segment tumors and categorize them more accurately than the existing state-of-the-art mechanisms.Communicated by Ramaswamy H. Sarma.

RAAGR2-Net: A brain tumor segmentation network using parallel processing of multiple spatial frames.

Brain tumors are one of the most fatal cancers. Magnetic Resonance Imaging (MRI) is a non-invasive method that provides multi-modal images containing important information regarding the tumor. Many contemporary techniques employ four modalities: T1-weighted (T1), T1-weighted with contrast (T1c), T2-weighted (T2), and fluid-attenuation-inversion-recovery (FLAIR), each of which provides unique and important characteristics for the location of each tumor. Although several modern procedures provide decent segmentation results on the multimodal brain tumor image segmentation benchmark (BraTS) dataset, they lack performance when evaluated simultaneously on all the regions of MRI images. Furthermore, there is still room for improvement due to parameter limitations and computational complexity. Therefore, in this work, a novel encoder-decoder-based architecture is proposed for the effective segmentation of brain tumor regions. Data pre-processing is performed by applying N4 bias field correction, z-score, and 0 to 1 resampling to facilitate model training. To minimize the loss of location information in different modules, a residual spatial pyramid pooling (RASPP) module is proposed. RASPP is a set of parallel layers using dilated convolution. In addition, an attention gate (AG) module is used to efficiently emphasize and restore the segmented output from extracted feature maps. The proposed modules attempt to acquire rich feature representations by combining knowledge from diverse feature maps and retaining their local information. The performance of the proposed deep network based on RASPP, AG, and recursive residual (R2) block termed RAAGR2-Net is evaluated on the BraTS benchmarks. The experimental results show that the suggested network outperforms existing networks that exhibit the usefulness of the proposed modules for "fine" segmentation. The code for this work is made available online at: https://github.com/Rehman1995/RAAGR2-Net.

A Sequential Machine Learning-cum-Attention Mechanism for Effective Segmentation of Brain Tumor.

Magnetic resonance imaging is the most generally utilized imaging methodology that permits radiologists to look inside the cerebrum using radio waves and magnets for tumor identification. However, it is tedious and complex to identify the tumorous and nontumorous regions due to the complexity in the tumorous region. Therefore, reliable and automatic segmentation and prediction are necessary for the segmentation of brain tumors. This paper proposes a reliable and efficient neural network variant, i.e., an attention-based convolutional neural network for brain tumor segmentation. Specifically, an encoder part of the UNET is a pre-trained VGG19 network followed by the adjacent decoder parts with an attention gate for segmentation noise induction and a denoising mechanism for avoiding overfitting. The dataset we are using for segmentation is BRATS'20, which comprises four different MRI modalities and one target mask file. The abovementioned algorithm resulted in a dice similarity coefficient of 0.83, 0.86, and 0.90 for enhancing, core, and whole tumors, respectively.

Ensembles of Convolutional Neural Networks for Survival Time Estimation of High-Grade Glioma Patients from Multimodal MRI.

Glioma is the most common type of primary malignant brain tumor. Accurate survival time prediction for glioma patients may positively impact treatment planning. In this paper, we develop an automatic survival time prediction tool for glioblastoma patients along with an effective solution to the limited availability of annotated medical imaging datasets. Ensembles of snapshots of three dimensional (3D) deep convolutional neural networks (CNN) are applied to Magnetic Resonance Image (MRI) data to predict survival time of high-grade glioma patients. Additionally, multi-sequence MRI images were used to enhance survival prediction performance. A novel way to leverage the potential of ensembles to overcome the limitation of labeled medical image availability is shown. This new classification method separates glioblastoma patients into long- and short-term survivors. The BraTS (Brain Tumor Image Segmentation) 2019 training dataset was used in this work. Each patient case consisted of three MRI sequences (T1CE, T2, and FLAIR). Our training set contained 163 cases while the test set included 46 cases. The best known prediction accuracy of 74% for this type of problem was achieved on the unseen test set.

Optimization of Deep Learning Based Brain Extraction in MRI for Low Resource Environments.

Brain extraction is an indispensable step in neuro-imaging with a direct impact on downstream analyses. Most such methods have been developed for non-pathologically affected brains, and hence tend to suffer in performance when applied on brains with pathologies, e.g., gliomas, multiple sclerosis, traumatic brain injuries. Deep Learning (DL) methodologies for healthcare have shown promising results, but their clinical translation has been limited, primarily due to these methods suffering from i) high computational cost, and ii) specific hardware requirements, e.g., DL acceleration cards. In this study, we explore the potential of mathematical optimizations, towards making DL methods amenable to application in low resource environments. We focus on both the qualitative and quantitative evaluation of such optimizations on an existing DL brain extraction method, designed for pathologically-affected brains and agnostic to the input modality. We conduct direct optimizations and quantization of the trained model (i.e., prior to inference on new data). Our results yield substantial gains, in terms of speedup, latency, through-put, and reduction in memory usage, while the segmentation performance of the initial and the optimized models remains stable, i.e., as quantified by both the Dice Similarity Coefficient and the Hausdorff Distance. These findings support post-training optimizations as a promising approach for enabling the execution of advanced DL methodologies on plain commercial-grade CPUs, and hence contributing to their translation in limited- and low- resource clinical environments.