Margaux Roulet

Vladyslav Zalevskyi, Thomas Sanchez, Margaux Roulet et al.

Segmentation of fetal brain tissue from magnetic resonance imaging (MRI) plays a crucial role in the study of in utero neurodevelopment. However, automated tools face substantial domain shift challenges as they must be robust to highly heterogeneous clinical data, often limited in numbers and lacking annotations. Indeed, high variability of the fetal brain morphology, MRI acquisition parameters, and superresolution reconstruction (SR) algorithms adversely affect the model's performance when evaluated out-of-domain. In this work, we introduce FetalSynthSeg, a domain randomization method to segment fetal brain MRI, inspired by SynthSeg. Our results show that models trained solely on synthetic data outperform models trained on real data in out-ofdomain settings, validated on a 120-subject cross-domain dataset. Furthermore, we extend our evaluation to 40 subjects acquired using lowfield (0.55T) MRI and reconstructed with novel SR models, showcasing robustness across different magnetic field strengths and SR algorithms. Leveraging a generative synthetic approach, we tackle the domain shift problem in fetal brain MRI and offer compelling prospects for applications in fields with limited and highly heterogeneous data.

Vladyslav Zalevskyi, Thomas Sanchez, Misha Kaandorp et al.

Accurate fetal brain tissue segmentation and biometric analysis are essential for studying brain development in utero. The FeTA Challenge 2024 advanced automated fetal brain MRI analysis by introducing biometry prediction as a new task alongside tissue segmentation. For the first time, our diverse multi-centric test set included data from a new low-field (0.55T) MRI dataset. Evaluation metrics were also expanded to include the topology-specific Euler characteristic difference (ED). Sixteen teams submitted segmentation methods, most of which performed consistently across both high- and low-field scans. However, longitudinal trends indicate that segmentation accuracy may be reaching a plateau, with results now approaching inter-rater variability. The ED metric uncovered topological differences that were missed by conventional metrics, while the low-field dataset achieved the highest segmentation scores, highlighting the potential of affordable imaging systems when paired with high-quality reconstruction. Seven teams participated in the biometry task, but most methods failed to outperform a simple baseline that predicted measurements based solely on gestational age, underscoring the challenge of extracting reliable biometric estimates from image data alone. Domain shift analysis identified image quality as the most significant factor affecting model generalization, with super-resolution pipelines also playing a substantial role. Other factors, such as gestational age, pathology, and acquisition site, had smaller, though still measurable, effects. Overall, FeTA 2024 offers a comprehensive benchmark for multi-class segmentation and biometry estimation in fetal brain MRI, underscoring the need for data-centric approaches, improved topological evaluation, and greater dataset diversity to enable clinically robust and generalizable AI tools.

Vladyslav Zalevskyi, Thomas Sanchez, Margaux Roulet et al.

Fetal brain tissue segmentation in magnetic resonance imaging (MRI) is a crucial tool that supports understanding of neurodevelopment, yet it faces challenges due to the heterogeneity of data coming from different scanners and settings, as well as data scarcity. Recent approaches based on domain randomization, like SynthSeg, have shown great potential for single-source domain generalization by simulating images with randomized contrast and image resolution from the label maps. In this work, we investigate how to maximize the out-of-domain (OOD) generalization potential of SynthSegbased methods in fetal brain MRI. Specifically, we demonstrate that the simple Gaussian mixture models employed in FetalSynthSeg outperform physics-informed generation methods in terms of OOD generalization. We further show that incorporating intensity clustering significantly enhances generalization in settings with limited label classes by producing more realistic synthetic data. By combining synthetic pretraining with fine-tuning on real images and applying weight-space interpolation between the two models, we propose DRIFTS as an effective and practical solution for single-source domain generalization. DRIFTS consistently outperforms current state-of-the-art models across multiple benchmarks and is, to our knowledge, the first method to achieve accurate brain tissue segmentation on fetal T1-weighted images. We validate our approach on 308 subjects from four datasets acquired at three different sites, covering a range of scanner field strengths (0.55T to 3T) and both T1w and T2w modalities. We conclude with five practical recommendations to guide the development of SynthSeg-based methods for other organs and imaging modalities.