Recently, Ultra-High Field MRI (UHF-MRI) has become more available and one of the best tools to study the brain. One common step in quantitative neuroimaging is the brain segmentation. However, the differences between UHF-MRI and 1.5-3T images are such that the automatic segmentation techniques optimized at these field strengths usually produce unsatisfactory segmentation results for UHF images. It has been particularly challenging to perform quantitative analyses as typically done with 1.5-3T data, considerably limiting the potential of UHF-MRI. Hence, we propose a novel Deep Learning (DL)-based segmentation technique called GOUHFI: Generalized and Optimized segmentation tool for Ultra-High Field Images, designed to segment UHF images of various contrasts and resolutions. For training, we used a total of 206 label maps from four datasets acquired at 3T, 7T and 9.4T. In contrast to most DL strategies, we used a previously proposed domain randomization approach, where synthetic images generated from the label maps were used for training a 3D U-Net. GOUHFI was tested on seven different datasets and compared to techniques like FastSurferVINN and CEREBRUM-7T. GOUHFI was able to the segment six contrasts and seven resolutions tested at 3T, 7T and 9.4T. Average Dice-Sorensen Similarity Coefficient (DSC) scores of 0.87, 0.84, 0.91 were computed against the ground truth segmentations at 3T, 7T and 9.4T. Moreover, GOUHFI demonstrated impressive resistance to the typical inhomogeneities observed at UHF-MRI, making it a new powerful segmentation tool that allows to apply the usual quantitative analysis pipelines also at UHF. Ultimately, GOUHFI is a promising new segmentation tool, being the first of its kind proposing a contrast- and resolution-agnostic alternative for UHF-MRI, making it the forthcoming alternative for neuroscientists working with UHF-MRI or even lower field strengths.
The goal of this work was to develop a deep network for whole-head segmentation, including clinical MRIs with abnormal anatomy, and compile the first public benchmark dataset for this purpose. We collected 91 MRIs with volumetric segmentation labels for a diverse set of human subjects (4 normal, 32 traumatic brain injuries, and 57 strokes). These clinical cases are characterized by extended cerebrospinal fluid (CSF) in regions normally containing the brain. Training labels were generated by manually correcting initial automated segmentations for skin/scalp, skull, CSF, gray matter, white matter, air cavity, and extracephalic air. We developed a MultiAxial network consisting of three 2D U-Net models that operate independently in sagittal, axial, and coronal planes and are then combined to produce a single 3D segmentation. The MultiAxial network achieved test-set Dice scores of 0.88 (median plus-minus 0.04). For brain tissue, it significantly outperforms existing brain segmentation methods (MultiAxial: 0.898 plus-minus 0.041, SynthSeg: 0.758 plus-minus 0.054, BrainChop: 0.757 plus-minus 0.125). The MultiAxial network gains in robustness by avoiding the need for coregistration with an atlas. It performed well in regions with abnormal anatomy and on images that have been de-identified. It enables more robust current flow modeling when incorporated into ROAST, a widely-used modeling toolbox for transcranial electric stimulation. We are releasing a state-of-the-art model for whole-head MRI segmentation, along with a dataset of 61 clinical MRIs and training labels, including non-brain structures. Together, the model and data may serve as a benchmark for future efforts.
Self-supervised deep learning has accelerated 2D natural image analysis but remains difficult to translate into 3D MRI, where data are scarce and pre-trained 2D backbones cannot capture volumetric context. We present a sequence-invariant self-supervised framework leveraging quantitative MRI (qMRI). By simulating multiple MRI contrasts from a single 3D qMRI scan and enforcing consistent representations across these contrasts, we learn anatomy-centric rather than sequence-specific features. This yields a robust 3D encoder that performs strongly across varied tasks and protocols. Experiments on healthy brain segmentation (IXI), stroke lesion segmentation (ARC), and MRI denoising show significant gains over baseline SSL approaches, especially in low-data settings (up to +8.3% Dice, +4.2 dB PSNR). Our model also generalises effectively to unseen sites, demonstrating potential for more scalable and clinically reliable volumetric analysis. All code and trained models are publicly available.
Automatic brain tissue segmentation from Magnetic Resonance Imaging (MRI) images is vital for accurate diagnosis and further analysis in medical imaging. Despite advancements in segmentation techniques, a comprehensive comparison between traditional statistical methods and modern deep learning approaches using pre-processing techniques like N4 Bias Field Correction and Anisotropic Diffusion remains underexplored. This study provides a comparative analysis of various segmentation models, including Probabilistic ATLAS, U-Net, nnU-Net, and LinkNet, enhanced with these pre-processing techniques to segment brain tissues (white matter (WM), grey matter (GM) and cerebrospinal fluid (CSF)) on the Internet Brain Segmentation Repository (IBSR18) dataset. Our results demonstrate that the 3D nnU-Net model outperforms others, achieving the highest mean Dice Coefficient score (0.937 +- 0.012), while the 2D nnU-Net model recorded the lowest mean Hausdorff Distance (5.005 +- 0.343 mm) and the lowest mean Absolute Volumetric Difference (3.695 +- 2.931 mm) across five unseen test samples. The findings highlight the superiority of nnU-Net models in brain tissue segmentation, particularly when combined with N4 Bias Field Correction and Anisotropic Diffusion pre-processing techniques. Our implemented code can be accessed via GitHub.
Accurate hippocampus segmentation in brain MRI is critical for studying cognitive and memory functions and diagnosing neurodevelopmental disorders. While high-field MRIs provide detailed imaging, low-field MRIs are more accessible and cost-effective, which eliminates the need for sedation in children, though they often suffer from lower image quality. In this paper, we present a novel deep-learning approach for the automatic segmentation of bilateral hippocampi in low-field MRIs. Extending recent advancements in infant brain segmentation to underserved communities through the use of low-field MRIs ensures broader access to essential diagnostic tools, thereby supporting better healthcare outcomes for all children. Inspired by our previous work, Co-BioNet, the proposed model employs a dual-view structure to enable mutual feature learning via high-frequency masking, enhancing segmentation accuracy by leveraging complementary information from different perspectives. Extensive experiments demonstrate that our method provides reliable segmentation outcomes for hippocampal analysis in low-resource settings. The code is publicly available at: https://github.com/himashi92/LoFiHippSeg.
Widely used traditional pipelines for subcortical brain segmentation are often inefficient and slow, particularly when processing large datasets. Furthermore, deep learning models face challenges due to the high resolution of MRI images and the large number of anatomical classes involved. To address these limitations, we developed a 3D patch-based hybrid CNN-Mamba model that leverages Mamba's selective scan algorithm, thereby enhancing segmentation accuracy and efficiency for 3D inputs. This retrospective study utilized 1784 T1-weighted MRI scans from a diverse, multi-site dataset of healthy individuals. The dataset was divided into training, validation, and testing sets with a 1076/345/363 split. The scans were obtained from 1.5T and 3T MRI machines. Our model's performance was validated against several benchmarks, including other CNN-Mamba, CNN-Transformer, and pure CNN networks, using FreeSurfer-generated ground truths. We employed the Dice Similarity Coefficient (DSC), Volume Similarity (VS), and Average Symmetric Surface Distance (ASSD) as evaluation metrics. Statistical significance was determined using the Wilcoxon signed-rank test with a threshold of P < 0.05. The proposed model achieved the highest overall performance across all metrics (DSC 0.88383; VS 0.97076; ASSD 0.33604), significantly outperforming all non-Mamba-based models (P < 0.001). While the model did not show significant improvement in DSC or VS compared to another Mamba-based model (P-values of 0.114 and 0.425), it demonstrated a significant enhancement in ASSD (P < 0.001) with approximately 20% fewer parameters. In conclusion, our proposed hybrid CNN-Mamba architecture offers an efficient and accurate approach for 3D subcortical brain segmentation, demonstrating potential advantages over existing methods. Code is available at: https://github.com/aaroncao06/MedSegMamba.
Brain extraction and removal of skull artifacts from magnetic resonance images (MRI) is an important preprocessing step in neuroimaging analysis. There are many tools developed to handle human fMRI images, which could involve manual steps for verifying results from brain segmentation that makes it time consuming and inefficient. In this study, we will use the segment anything model (SAM), a freely available neural network released by Meta[4], which has shown promising results in many generic segmentation applications. We will analyze the efficiency of SAM for neuroimaging brain segmentation by removing skull artifacts. The results of the experiments showed promising results that explore using automated segmentation algorithms for neuroimaging without the need to train on custom medical imaging dataset.
Recent learning-based approaches have made astonishing advances in calibrated medical imaging like computerized tomography (CT), yet they struggle to generalize in uncalibrated modalities -- notably magnetic resonance (MR) imaging, where performance is highly sensitive to the differences in MR contrast, resolution, and orientation. This prevents broad applicability to diverse real-world clinical protocols. We introduce Brain-ID, an anatomical representation learning model for brain imaging. With the proposed "mild-to-severe" intra-subject generation, Brain-ID is robust to the subject-specific brain anatomy regardless of the appearance of acquired images (e.g., contrast, deformation, resolution, artifacts). Trained entirely on synthetic data, Brain-ID readily adapts to various downstream tasks through only one layer. We present new metrics to validate the intra- and inter-subject robustness of Brain-ID features, and evaluate their performance on four downstream applications, covering contrast-independent (anatomy reconstruction/contrast synthesis, brain segmentation), and contrast-dependent (super-resolution, bias field estimation) tasks. Extensive experiments on six public datasets demonstrate that Brain-ID achieves state-of-the-art performance in all tasks on different MRI modalities and CT, and more importantly, preserves its performance on low-resolution and small datasets. Code is available at https://github.com/peirong26/Brain-ID.
Domain Adaptation (DA) is important for deep learning-based medical image segmentation models to deal with testing images from a new target domain. As the source-domain data are usually unavailable when a trained model is deployed at a new center, Source-Free Domain Adaptation (SFDA) is appealing for data and annotation-efficient adaptation to the target domain. However, existing SFDA methods have a limited performance due to lack of sufficient supervision with source-domain images unavailable and target-domain images unlabeled. We propose a novel Uncertainty-aware Pseudo Label guided (UPL) SFDA method for medical image segmentation. Specifically, we propose Target Domain Growing (TDG) to enhance the diversity of predictions in the target domain by duplicating the pre-trained model's prediction head multiple times with perturbations. The different predictions in these duplicated heads are used to obtain pseudo labels for unlabeled target-domain images and their uncertainty to identify reliable pseudo labels. We also propose a Twice Forward pass Supervision (TFS) strategy that uses reliable pseudo labels obtained in one forward pass to supervise predictions in the next forward pass. The adaptation is further regularized by a mean prediction-based entropy minimization term that encourages confident and consistent results in different prediction heads. UPL-SFDA was validated with a multi-site heart MRI segmentation dataset, a cross-modality fetal brain segmentation dataset, and a 3D fetal tissue segmentation dataset. It improved the average Dice by 5.54, 5.01 and 6.89 percentage points for the three tasks compared with the baseline, respectively, and outperformed several state-of-the-art SFDA methods.
Brain segmentation from neonatal MRI images is a very challenging task due to large changes in the shape of cerebral structures and variations in signal intensities reflecting the gestational process. In this context, there is a clear need for segmentation techniques that are robust to variations in image contrast and to the spatial configuration of anatomical structures. In this work, we evaluate the potential of synthetic learning, a contrast-independent model trained using synthetic images generated from the ground truth labels of very few subjects.We base our experiments on the dataset released by the developmental Human Connectome Project, for which high-quality T1- and T2-weighted images are available for more than 700 babies aged between 26 and 45 weeks post-conception. First, we confirm the impressive performance of a standard Unet trained on a few T2-weighted volumes, but also confirm that such models learn intensity-related features specific to the training domain. We then evaluate the synthetic learning approach and confirm its robustness to variations in image contrast by reporting the capacity of such a model to segment both T1- and T2-weighted images from the same individuals. However, we observe a clear influence of the age of the baby on the predictions. We improve the performance of this model by enriching the synthetic training set with realistic motion artifacts and over-segmentation of the white matter. Based on extensive visual assessment, we argue that the better performance of the model trained on real T2w data may be due to systematic errors in the ground truth. We propose an original experiment combining two definitions of the ground truth allowing us to show that learning from real data will reproduce any systematic bias from the training set, while synthetic models can avoid this limitation. Overall, our experiments confirm that synthetic learning is an effective solution for segmenting neonatal brain MRI. Our adapted synthetic learning approach combines key features that will be instrumental for large multi-site studies and clinical applications.
Whole brain segmentation with magnetic resonance imaging (MRI) enables the non-invasive measurement of brain regions, including total intracranial volume (TICV) and posterior fossa volume (PFV). Enhancing the existing whole brain segmentation methodology to incorporate intracranial measurements offers a heightened level of comprehensiveness in the analysis of brain structures. Despite its potential, the task of generalizing deep learning techniques for intracranial measurements faces data availability constraints due to limited manually annotated atlases encompassing whole brain and TICV/PFV labels. In this paper, we enhancing the hierarchical transformer UNesT for whole brain segmentation to achieve segmenting whole brain with 133 classes and TICV/PFV simultaneously. To address the problem of data scarcity, the model is first pretrained on 4859 T1-weighted (T1w) 3D volumes sourced from 8 different sites. These volumes are processed through a multi-atlas segmentation pipeline for label generation, while TICV/PFV labels are unavailable. Subsequently, the model is finetuned with 45 T1w 3D volumes from Open Access Series Imaging Studies (OASIS) where both 133 whole brain classes and TICV/PFV labels are available. We evaluate our method with Dice similarity coefficients(DSC). We show that our model is able to conduct precise TICV/PFV estimation while maintaining the 132 brain regions performance at a comparable level. Code and trained model are available at: https://github.com/MASILab/UNesT/tree/main/wholebrainSeg.
Recent deep learning models have attracted substantial attention in infant brain analysis. These models have performed state-of-the-art performance, such as semi-supervised techniques (e.g., Temporal Ensembling, mean teacher). However, these models depend on an encoder-decoder structure with stacked local operators to gather long-range information, and the local operators limit the efficiency and effectiveness. Besides, the $MRI$ data contain different tissue properties ($TPs$) such as $T1$ and $T2$. One major limitation of these models is that they use both data as inputs to the segment process, i.e., the models are trained on the dataset once, and it requires much computational and memory requirements during inference. In this work, we address the above limitations by designing a new deep-learning model, called 3D-DenseUNet, which works as adaptable global aggregation blocks in down-sampling to solve the issue of spatial information loss. The self-attention module connects the down-sampling blocks to up-sampling blocks, and integrates the feature maps in three dimensions of spatial and channel, effectively improving the representation potential and discriminating ability of the model. Additionally, we propose a new method called Two Independent Teachers ($2IT$), that summarizes the model weights instead of label predictions. Each teacher model is trained on different types of brain data, $T1$ and $T2$, respectively. Then, a fuse model is added to improve test accuracy and enable training with fewer parameters and labels compared to the Temporal Ensembling method without modifying the network architecture. Empirical results demonstrate the effectiveness of the proposed method. The code is available at https://github.com/AfifaKhaled/Two-Independent-Teachers-are-Better-Role-Model.
Deep learning based pipelines for semantic segmentation often ignore structural information available on annotated images used for training. We propose a novel post-processing module enforcing structural knowledge about the objects of interest to improve segmentation results provided by deep learning. This module corresponds to a "many-to-one-or-none" inexact graph matching approach, and is formulated as a quadratic assignment problem. Our approach is compared to a CNN-based segmentation (for various CNN backbones) on two public datasets, one for face segmentation from 2D RGB images (FASSEG), and the other for brain segmentation from 3D MRIs (IBSR). Evaluations are performed using two types of structural information (distances and directional relations, , this choice being a hyper-parameter of our generic framework). On FASSEG data, results show that our module improves accuracy of the CNN by about 6.3% (the Hausdorff distance decreases from 22.11 to 20.71). On IBSR data, the improvement is of 51% (the Hausdorff distance decreases from 11.01 to 5.4). In addition, our approach is shown to be resilient to small training datasets that often limit the performance of deep learning methods: the improvement increases as the size of the training dataset decreases.
Transformer-based models, capable of learning better global dependencies, have recently demonstrated exceptional representation learning capabilities in computer vision and medical image analysis. Transformer reformats the image into separate patches and realizes global communication via the self-attention mechanism. However, positional information between patches is hard to preserve in such 1D sequences, and loss of it can lead to sub-optimal performance when dealing with large amounts of heterogeneous tissues of various sizes in 3D medical image segmentation. Additionally, current methods are not robust and efficient for heavy-duty medical segmentation tasks such as predicting a large number of tissue classes or modeling globally inter-connected tissue structures. To address such challenges and inspired by the nested hierarchical structures in vision transformer, we proposed a novel 3D medical image segmentation method (UNesT), employing a simplified and faster-converging transformer encoder design that achieves local communication among spatially adjacent patch sequences by aggregating them hierarchically. We extensively validate our method on multiple challenging datasets, consisting of multiple modalities, anatomies, and a wide range of tissue classes, including 133 structures in the brain, 14 organs in the abdomen, 4 hierarchical components in the kidneys, inter-connected kidney tumors and brain tumors. We show that UNesT consistently achieves state-of-the-art performance and evaluate its generalizability and data efficiency. Particularly, the model achieves whole brain segmentation task complete ROI with 133 tissue classes in a single network, outperforming prior state-of-the-art method SLANT27 ensembled with 27 networks.
Every year, millions of brain MRI scans are acquired in hospitals, which is a figure considerably larger than the size of any research dataset. Therefore, the ability to analyse such scans could transform neuroimaging research. Yet, their potential remains untapped, since no automated algorithm is robust enough to cope with the high variability in clinical acquisitions (MR contrasts, resolutions, orientations, artefacts, subject populations). Here we present SynthSeg+, an AI segmentation suite that enables, for the first time, robust analysis of heterogeneous clinical datasets. In addition to whole-brain segmentation, SynthSeg+ also performs cortical parcellation, intracranial volume estimation, and automated detection of faulty segmentations (mainly caused by scans of very low quality). We demonstrate SynthSeg+ in seven experiments, including an ageing study on 14,000 scans, where it accurately replicates atrophy patterns observed on data of much higher quality. SynthSeg+ is publicly released as a ready-to-use tool to unlock the potential of quantitative morphometry.
Medical images used in clinical practice are heterogeneous and not the same quality as scans studied in academic research. Preprocessing breaks down in extreme cases when anatomy, artifacts, or imaging parameters are unusual or protocols are different. Methods robust to these variations are most needed. A novel deep learning method is proposed for fast and accurate segmentation of the human brain into 132 regions. The proposed model uses an efficient U-Net-like network and benefits from the intersection points of different views and hierarchical relations for the fusion of the orthogonal 2D planes and brain labels during the end-to-end training. Weakly supervised learning is deployed to take the advantage of partially labeled data for the whole brain segmentation and estimation of the intracranial volume (ICV). Moreover, data augmentation is used to expand the magnetic resonance imaging (MRI) data by generating realistic brain scans with high variability for robust training of the model while preserving data privacy. The proposed method can be applied to brain MRI data including skull or any other artifacts without preprocessing the images or a drop in performance. Several experiments using different atlases are conducted to evaluate the segmentation performance of the trained model compared to the state-of-the-art, and the results show higher segmentation accuracy and robustness of the proposed model compared to the existing methods across different intra- and inter-domain datasets.
In this paper we describe and validate a longitudinal method for whole-brain segmentation of longitudinal MRI scans. It builds upon an existing whole-brain segmentation method that can handle multi-contrast data and robustly analyze images with white matter lesions. This method is here extended with subject-specific latent variables that encourage temporal consistency between its segmentation results, enabling it to better track subtle morphological changes in dozens of neuroanatomical structures and white matter lesions. We validate the proposed method on multiple datasets of control subjects and patients suffering from Alzheimer's disease and multiple sclerosis, and compare its results against those obtained with its original cross-sectional formulation and two benchmark longitudinal methods. The results indicate that the method attains a higher test-retest reliability, while being more sensitive to longitudinal disease effect differences between patient groups. An implementation is publicly available as part of the open-source neuroimaging package FreeSurfer.
The automatic segmentation of perinatal brain structures in magnetic resonance imaging (MRI) is of utmost importance for the study of brain growth and related complications. While different methods exist for adult and pediatric MRI data, there is a lack for automatic tools for the analysis of perinatal imaging. In this work, a new pipeline for fetal and neonatal segmentation has been developed. We also report the creation of two new fetal atlases, and their use within the pipeline for atlas-based segmentation, based on novel registration methods. The pipeline is also able to extract cortical and pial surfaces and compute features, such as curvature, thickness, sulcal depth, and local gyrification index. Results show that the introduction of the new templates together with our segmentation strategy leads to accurate results when compared to expert annotations, as well as better performances when compared to a reference pipeline (developing Human Connectome Project (dHCP)), for both early and late-onset fetal brains.
Fetal brain segmentation is an important first step for slice-level motion correction and slice-to-volume reconstruction in fetal MRI. Fast and accurate segmentation of the fetal brain on fetal MRI is required to achieve real-time fetal head pose estimation and motion tracking for slice re-acquisition and steering. To address this critical unmet need, in this work we analyzed the speed-accuracy performance of a variety of deep neural network models, and devised a symbolically small convolutional neural network that combines spatial details at high resolution with context features extracted at lower resolutions. We used multiple branches with skip connections to maintain high accuracy while devising a parallel combination of convolution and pooling operations as an input downsampling module to further reduce inference time. We trained our model as well as eight alternative, state-of-the-art networks with manually-labeled fetal brain MRI slices and tested on two sets of normal and challenging test cases. Experimental results show that our network achieved the highest accuracy and lowest inference time among all of the compared state-of-the-art real-time segmentation methods. We achieved average Dice scores of 97.99\% and 84.04\% on the normal and challenging test sets, respectively, with an inference time of 3.36 milliseconds per image on an NVIDIA GeForce RTX 2080 Ti. Code, data, and the trained models are available at https://github.com/bchimagine/real_time_fetal_brain_segmentation.
Domain Adaptation (DA) has recently raised strong interests in the medical imaging community. While a large variety of DA techniques has been proposed for image segmentation, most of these techniques have been validated either on private datasets or on small publicly available datasets. Moreover, these datasets mostly addressed single-class problems. To tackle these limitations, the Cross-Modality Domain Adaptation (crossMoDA) challenge was organised in conjunction with the 24th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI 2021). CrossMoDA is the first large and multi-class benchmark for unsupervised cross-modality DA. The challenge's goal is to segment two key brain structures involved in the follow-up and treatment planning of vestibular schwannoma (VS): the VS and the cochleas. Currently, the diagnosis and surveillance in patients with VS are performed using contrast-enhanced T1 (ceT1) MRI. However, there is growing interest in using non-contrast sequences such as high-resolution T2 (hrT2) MRI. Therefore, we created an unsupervised cross-modality segmentation benchmark. The training set provides annotated ceT1 (N=105) and unpaired non-annotated hrT2 (N=105). The aim was to automatically perform unilateral VS and bilateral cochlea segmentation on hrT2 as provided in the testing set (N=137). A total of 16 teams submitted their algorithm for the evaluation phase. The level of performance reached by the top-performing teams is strikingly high (best median Dice - VS:88.4%; Cochleas:85.7%) and close to full supervision (median Dice - VS:92.5%; Cochleas:87.7%). All top-performing methods made use of an image-to-image translation approach to transform the source-domain images into pseudo-target-domain images. A segmentation network was then trained using these generated images and the manual annotations provided for the source image.