Mathilde Gajda Faanes

Mathilde Gajda Faanes, David Bouget, Asgeir S. Jakola et al.

T2-weighted fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) scans are important for diagnosis, treatment planning and monitoring of brain tumors. Depending on the brain tumor type, the FLAIR hyperintensity volume is an important measure to asses the tumor volume or surrounding edema, and an automatic segmentation of this would be useful in the clinic. In this study, around 5000 FLAIR images of various tumors types and acquisition time points from different centers were used to train a unified FLAIR hyperintensity segmentation model using an Attention U-Net architecture. The performance was compared against dataset specific models, and was validated on different tumor types, acquisition time points and against BraTS. The unified model achieved an average Dice score of 88.65\% for pre-operative meningiomas, 80.08% for pre-operative metastasis, 90.92% for pre-operative and 84.60% for post-operative gliomas from BraTS, and 84.47% for pre-operative and 61.27\% for post-operative lower grade gliomas. In addition, the results showed that the unified model achieved comparable segmentation performance to the dataset specific models on their respective datasets, and enables generalization across tumor types and acquisition time points, which facilitates the deployment in a clinical setting. The model is integrated into Raidionics, an open-source software for CNS tumor analysis.

Mathilde Faanes, Ragnhild Holden Helland, Ole Solheim et al.

Automatic segmentation of brain tumors in intra-operative ultrasound (iUS) images could facilitate localization of tumor tissue during resection surgery. The lack of large annotated datasets limits the current models performances. In this paper, we investigated the use of tumor annotations in magnetic resonance imaging (MRI) scans, which are more accessible than annotations in iUS images, for training of deep learning models for iUS brain tumor segmentation. We used 180 annotated MRI scans with corresponding unannotated iUS images, and 29 annotated iUS images. Image registration was performed to transfer the MRI annotations to the corresponding iUS images before training the nnU-Net model with different configurations of the data and label origins. The results showed no significant difference in Dice score for a model trained with only MRI annotated tumors compared to models trained with only iUS annotations and both, and to expert annotations, indicating that MRI tumor annotations can be used as a substitute for iUS tumor annotations to train a deep learning model for automatic brain tumor segmentation in iUS images. The best model obtained an average Dice score of $0.62\pm0.31$, compared to $0.67\pm0.25$ for an expert neurosurgeon, where the performance on larger tumors were similar, but lower for the models on smaller tumors. In addition, the results showed that removing smaller tumors from the training sets improved the results. The main models are available here: https://github.com/mathildefaanes/us_brain_tumor_segmentation/tree/main