Brain-Shift: Unsupervised Pseudo-Healthy Brain Synthesis for Novel Biomarker Extraction in Chronic Subdural Hematoma
This addresses the need for better prognostic metrics in cSDH treatment, offering a novel approach to extract deformation-based biomarkers, though it is domain-specific and incremental in medical imaging.
The paper tackles the problem of quantifying local 3D brain deformation in chronic subdural hematoma (cSDH) by proposing an unsupervised pseudo-healthy brain synthesis method, resulting in biomarkers that identify patients requiring surgery from CT scans of 121 patients.
Chronic subdural hematoma (cSDH) is a common neurological condition characterized by the accumulation of blood between the brain and the dura mater. This accumulation of blood can exert pressure on the brain, potentially leading to fatal outcomes. Treatment options for cSDH are limited to invasive surgery or non-invasive management. Traditionally, the midline shift, hand-measured by experts from an ideal sagittal plane, and the hematoma volume have been the primary metrics for quantifying and analyzing cSDH. However, these approaches do not quantify the local 3D brain deformation caused by cSDH. We propose a novel method using anatomy-aware unsupervised diffeomorphic pseudo-healthy synthesis to generate brain deformation fields. The deformation fields derived from this process are utilized to extract biomarkers that quantify the shift in the brain due to cSDH. We use CT scans of 121 patients for training and validation of our method and find that our metrics allow the identification of patients who require surgery. Our results indicate that automatically obtained brain deformation fields might contain prognostic value for personalized cSDH treatment. Our implementation is available on: github.com/Barisimre/brain-morphing