Andreas M. Rauschecker

Jeffrey D. Rudie, Rachit Saluja, David A. Weiss et al.

The University of California San Francisco Brain Metastases Stereotactic Radiosurgery (UCSF-BMSR) dataset is a public, clinical, multimodal brain MRI dataset consisting of 560 brain MRIs from 412 patients with expert annotations of 5136 brain metastases. Data consists of registered and skull stripped T1 post-contrast, T1 pre-contrast, FLAIR and subtraction (T1 pre-contrast - T1 post-contrast) images and voxelwise segmentations of enhancing brain metastases in NifTI format. The dataset also includes patient demographics, surgical status and primary cancer types. The UCSF-BSMR has been made publicly available in the hopes that researchers will use these data to push the boundaries of AI applications for brain metastases. The dataset is freely available for non-commercial use at https://imagingdatasets.ucsf.edu/dataset/1

Shiv Ghosh, Junayd Lateef, Chih-Hua et al.

Brain tumor diagnosis is largely dependent on Magnetic Resonance Imaging (MRI) evaluation, which requires radiologists to synthesize thousands of images across multiple 3D sequences and longitudinal studies. This process requires advanced neuro-radiology training, poses substantial cognitive load, and is highly time-consuming. Despite increasing demands in radiology, this expertise is difficult to scale, straining the current health systems. Vision-Language Models (VLMs) provide an opportunity to reduce this burden through a semi-automated, interactive interpretation of complex brain MRIs. However, they are currently underutilized in neuro-oncology due to a lack of specialized benchmarks for evaluating them. We introduce a clinically relevant visual question answering (VQA) benchmark -- the UCSF-PDGM-VQA dataset -- consisting of 2,387 QA pairs from 473 glioma-related MRI studies in the public UCSF-PDGM dataset. We further establish a performance baseline for six state-of-the-art vision-language models (VLMs) and one large language model on this dataset. We find that current models are incapable of effectively processing multi-sequence, 3-dimensional MRI scans, thus resulting in a suppression of visual features and over-reliance on language priors, causing modality collapse. These findings underscore a critical deficiency in current model reliability and safety within clinical settings, necessitating the development of robust, domain-specific VLMs.

Dominic LaBella, Ujjwal Baid, Omaditya Khanna et al.

We describe the design and results from the BraTS 2023 Intracranial Meningioma Segmentation Challenge. The BraTS Meningioma Challenge differed from prior BraTS Glioma challenges in that it focused on meningiomas, which are typically benign extra-axial tumors with diverse radiologic and anatomical presentation and a propensity for multiplicity. Nine participating teams each developed deep-learning automated segmentation models using image data from the largest multi-institutional systematically expert annotated multilabel multi-sequence meningioma MRI dataset to date, which included 1000 training set cases, 141 validation set cases, and 283 hidden test set cases. Each case included T2, FLAIR, T1, and T1Gd brain MRI sequences with associated tumor compartment labels delineating enhancing tumor, non-enhancing tumor, and surrounding non-enhancing FLAIR hyperintensity. Participant automated segmentation models were evaluated and ranked based on a scoring system evaluating lesion-wise metrics including dice similarity coefficient (DSC) and 95% Hausdorff Distance. The top ranked team had a lesion-wise median dice similarity coefficient (DSC) of 0.976, 0.976, and 0.964 for enhancing tumor, tumor core, and whole tumor, respectively and a corresponding average DSC of 0.899, 0.904, and 0.871, respectively. These results serve as state-of-the-art benchmarks for future pre-operative meningioma automated segmentation algorithms. Additionally, we found that 1286 of 1424 cases (90.3%) had at least 1 compartment voxel abutting the edge of the skull-stripped image edge, which requires further investigation into optimal pre-processing face anonymization steps.

Andrew G. Breithaupt, Michael Weiner, Alice Tang et al.

Healthcare systems are struggling to meet the growing demand for neurological care, particularly in Alzheimer's disease and related dementias (ADRD). We propose that LLM-based generative AI systems can enhance clinician capabilities to approach specialist-level assessment and decision-making in ADRD care at scale. This article presents a comprehensive six-phase roadmap for responsible design and integration of such systems into ADRD care: (1) high-quality standardized data collection across modalities; (2) decision support; (3) clinical integration enhancing workflows; (4) rigorous validation and monitoring protocols; (5) continuous learning through clinical feedback; and (6) robust ethics and risk management frameworks. This human centered approach optimizes clinicians' capabilities in comprehensive data collection, interpretation of complex clinical information, and timely application of relevant medical knowledge while prioritizing patient safety, healthcare equity, and transparency. Though focused on ADRD, these principles offer broad applicability across medical specialties facing similar systemic challenges.

Evan Calabrese, Javier E. Villanueva-Meyer, Jeffrey D. Rudie et al.

Here we present the University of California San Francisco Preoperative Diffuse Glioma MRI (UCSF-PDGM) dataset. The UCSF-PDGM dataset includes 500 subjects with histopathologically-proven diffuse gliomas who were imaged with a standardized 3 Tesla preoperative brain tumor MRI protocol featuring predominantly 3D imaging, as well as advanced diffusion and perfusion imaging techniques. The dataset also includes isocitrate dehydrogenase (IDH) mutation status for all cases and O6-methylguanine-DNA methyltransferase (MGMT) promotor methylation status for World Health Organization (WHO) grade III and IV gliomas. The UCSF-PDGM has been made publicly available in the hopes that researchers around the world will use these data to continue to push the boundaries of AI applications for diffuse gliomas.