Patrice Grehten

Misha P. T Kaandorp, Damola Agbelese, Hosna Asma-ull et al.

Developing new methods for the automated analysis of clinical fetal and neonatal MRI data is limited by the scarcity of annotated pathological datasets and privacy concerns that often restrict data sharing, hindering the effectiveness of deep learning models. We address this in two ways. First, we introduce Fetal&Neonatal-DDPM, a novel diffusion model framework designed to generate high-quality synthetic pathological fetal and neonatal MRIs from semantic label images. Second, we enhance training data by modifying healthy label images through morphological alterations to simulate conditions such as ventriculomegaly, cerebellar and pontocerebellar hypoplasia, and microcephaly. By leveraging Fetal&Neonatal-DDPM, we synthesize realistic pathological MRIs from these modified pathological label images. Radiologists rated the synthetic MRIs as significantly (p < 0.05) superior in quality and diagnostic value compared to real MRIs, demonstrating features such as blood vessels and choroid plexus, and improved alignment with label annotations. Synthetic pathological data enhanced state-of-the-art nnUNet segmentation performance, particularly for severe ventriculomegaly cases, with the greatest improvements achieved in ventricle segmentation (Dice scores: 0.9253 vs. 0.7317). This study underscores the potential of generative AI as transformative tool for data augmentation, offering improved segmentation performance in pathological cases. This development represents a significant step towards improving analysis and segmentation accuracy in prenatal imaging, and also offers new ways for data anonymization through the generation of pathologic image data.

A. Piffer, J. A. Buchner, A. G. Gennari et al.

Background Brain tumours are the most common solid malignancies in children, encompassing diverse histological, molecular subtypes and imaging features and outcomes. Paediatric brain tumours (PBTs), including high- and low-grade gliomas (HGG, LGG), medulloblastomas (MB), ependymomas, and rarer forms, pose diagnostic and therapeutic challenges. Deep learning (DL)-based segmentation offers promising tools for tumour delineation, yet its performance across heterogeneous PBT subtypes and MRI protocols remains uncertain. Methods A retrospective single-centre cohort of 174 paediatric patients with HGG, LGG, medulloblastomas (MB), ependymomas, and other rarer subtypes was used. MRI sequences included T1, T1 post-contrast (T1-C), T2, and FLAIR. Manual annotations were provided for four tumour subregions: whole tumour (WT), T2-hyperintensity (T2H), enhancing tumour (ET), and cystic component (CC). A 3D nnU-Net model was trained and tested (121/53 split), with segmentation performance assessed using the Dice similarity coefficient (DSC) and compared against intra- and inter-rater variability. Results The model achieved robust performance for WT and T2H (mean DSC: 0.85), comparable to human annotator variability (mean DSC: 0.86). ET segmentation was moderately accurate (mean DSC: 0.75), while CC performance was poor. Segmentation accuracy varied by tumour type, MRI sequence combination, and location. Notably, T1, T1-C, and T2 alone produced results nearly equivalent to the full protocol. Conclusions DL is feasible for PBTs, particularly for T2H and WT. Challenges remain for ET and CC segmentation, highlighting the need for further refinement. These findings support the potential for protocol simplification and automation to enhance volumetric assessment and streamline paediatric neuro-oncology workflows.