Multimodal Volume-Aware Detection and Segmentation for Brain Metastases Radiosurgery
Massachusetts General Hospital（麻省总医院）；Massachusetts Institute of Technology（麻省理工学院）；National Taiwan University Hospital（台湾大学医院）；Vysioneer Inc.（Vysioneer公司）
Stereotactic radiosurgery (SRS), which delivers high doses of irradiation in a single or few shots to small targets, has been a standard of care for brain metastases. While very effective, SRS currently requires manually intensive delineation of tumors. In this work, we present a deep learning approach for automated detection and segmentation of brain metastases using multimodal imaging and ensemble neural networks. In order to address small and multiple brain metastases, we further propose a volume-aware Dice loss which optimizes model performance using the information of lesion size. This work surpasses current benchmark levels and demonstrates a reliable AI-assisted system for SRS treatment planning for multiple brain metastases.
The University of California San Francisco Brain Metastases Stereotactic Radiosurgery (UCSF-BMSR) MRI Dataset
University of California San Francisco（加州大学旧金山分校）；University of California, San Diego（加州大学圣地亚哥分校）；University of Pennsylvania（宾夕法尼亚大学）；Duke University（杜克大学）
Skolkovo Institute of Science and Technology（斯科尔科沃科学技术学院）；Kharkevich Institute for Information Transmission Problems（哈尔克维奇信息传输问题研究所）；Moscow Institute of Physics and Technology（莫斯科物理技术学院）；Moscow Gamma-Knife Center（莫斯科伽马刀中心）；Burdenko Neurosurgery Institute（布尔坚科神经外科研究所）
Stereotactic radiosurgery is a minimally-invasive treatment option for a large number of patients with intracranial tumors. As part of the therapy treatment, accurate delineation of brain tumors is of great importance. However, slice-by-slice manual segmentation on T1c MRI could be time-consuming (especially for multiple metastases) and subjective. In our work, we compared several deep convolutional networks architectures and training procedures and evaluated the best model in a radiation therapy department for three types of brain tumors: meningiomas, schwannomas and multiple brain metastases…
National Taiwan University（台湾大学）；Santa Clara University（圣克拉拉大学）；QNAP Systems, Inc（威联通科技股份有限公司）；Taipei Hospital（台北医院）；National Taiwan University Hospital（台湾大学附属医院）
Semantic segmentation of medical images with deep learning models is rapidly developed. In this study, we benchmarked state-of-the-art deep learning segmentation algorithms on our clinical stereotactic radiosurgery dataset, demonstrating the strengths and weaknesses of these algorithms in a fairly practical scenario. In particular, we compared the model performances with respect to their sampling method, model architecture, and the choice of loss functions, identifying the suitable settings for their applications and shedding light on the possible improvements.
Universitätsklinikum Erlangen（埃尔朗根大学医院）；Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU)（埃尔朗根-纽伦堡弗里德里希-亚历山大大学（FAU））；Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN)（埃尔朗根-EMN综合癌症中心（CCC ER-EMN））
Brain metastases occur frequently in patients with metastatic cancer. Early and accurate detection of brain metastases is very essential for treatment planning and prognosis in radiation therapy. To improve brain metastasis detection performance with deep learning, a custom detection loss called volume-level sensitivity-specificity (VSS) is proposed, which rates individual metastasis detection sensitivity and specificity in (sub-)volume levels. As sensitivity and precision are always a trade-off in a metastasis level, either a high sensitivity or a high precision can be achieved by adjusting t…
Oslo University Hospital（奥斯陆大学医院）；Stanford University（斯坦福大学）
The purpose was to assess the clinical value of a novel DropOut model for detecting and segmenting brain metastases, in which a neural network is trained on four distinct MRI sequences using an input dropout layer, thus simulating the scenario of missing MRI data by training on the full set and all possible subsets of the input data. This retrospective, multi-center study, evaluated 165 patients with brain metastases. A deep learning based segmentation model for automatic segmentation of brain metastases, named DropOut, was trained on multi-sequence MRI from 100 patients, and validated/tested …
FANCL: Feature-Guided Attention Network with Curriculum Learning for Brain Metastases Segmentation
Digital Medical Research Center, School of Basic Medical Science, Fudan University（复旦大学基础医学院数字医学研究中心）；Shanghai Key Lab of Medical Image Computing and Computer Assisted Intervention（上海市医学影像计算与计算机辅助介入重点实验室）
The detection of brain metastases (BM) in their early stages could have a positive impact on the outcome of cancer patients. We previously developed a framework for detecting small BM (with diameters of less than 15mm) in T1-weighted Contrast-Enhanced 3D Magnetic Resonance images (T1c) to assist medical experts in this time-sensitive and high-stakes task. The framework utilizes a dedicated convolutional neural network (CNN) trained using labeled T1c data, where the ground truth BM segmentations were provided by a radiologist. This study aims to advance the framework with a noisy student-based …
Detecting and segmenting brain metastases is a tedious and time-consuming task for many radiologists, particularly with the growing use of multi-sequence 3D imaging. This study demonstrates automated detection and segmentation of brain metastases on multi-sequence MRI using a deep learning approach based on a fully convolution neural network (CNN). In this retrospective study, a total of 156 patients with brain metastases from several primary cancers were included. Pre-therapy MR images (1.5T and 3T) included pre- and post-gadolinium T1-weighted 3D fast spin echo, post-gadolinium T1-weighted 3…
Rensselaer Polytechnic Institute（伦斯勒理工学院）；Wake Forest School of Medicine（维克森林大学医学院）
Treatment decisions for brain metastatic disease rely on knowledge of the primary organ site, and currently made with biopsy and histology. Here we develop a novel deep learning approach for accurate non-invasive digital histology with whole-brain MRI data. Our IRB-approved single-site retrospective study was comprised of patients (n=1,399) referred for MRI treatment-planning and gamma knife radiosurgery over 21 years. Contrast-enhanced T1-weighted and T2-weighted Fluid-Attenuated Inversion Recovery brain MRI exams (n=1,582) were preprocessed and input to the proposed deep learning workflow fo…
Multicenter Privacy-Preserving Model Training for Deep Learning Brain Metastases Autosegmentation
Friedrich-Alexander-Universität Erlangen-Nürnberg（埃尔朗根-纽伦堡弗里德里希-亚历山大大学）；Universitätsklinikum Erlangen（埃尔朗根大学医院）；Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN)（埃尔朗根-EMN综合癌症中心）；Bavarian Cancer Research Center (BZKF)（巴伐利亚癌症研究中心）；University of Zurich（苏黎世大学）；University Hospital Zurich（苏黎世大学医院）
Early detection of brain metastases (BM) is one of the determining factors for the successful treatment of patients with cancer; however, the accurate detection of small BM lesions (< 15mm) remains a challenging task. We previously described a framework for the detection of small BM in single-sequence gadolinium-enhanced T1-weighted 3D MRI datasets. It combined classical image processing (IP) with a dedicated convolutional neural network, taking approximately 30 seconds to process each dataset due to computation-intensive IP stages. To overcome the speed limitation, this study aims to reformul…
A medical AI system's generalizability describes the continuity of its performance acquired from varying geographic, historical, and methodologic settings. Previous literature on this topic has mostly focused on "how" to achieve high generalizability with limited success. Instead, we aim to understand "when" the generalizability is achieved: Our study presents a medical AI system that could estimate its generalizability status for unseen data on-the-fly. We introduce a latent space mapping (LSM) approach utilizing Frechet distance loss to force the underlying training data distribution into a …
Brain Metastases (BM) complicate 20-40% of cancer cases. BM lesions can present as punctate (1 mm) foci, requiring high-precision Magnetic Resonance Imaging (MRI) in order to prevent inadequate or delayed BM treatment. However, BM lesion detection remains challenging partly due to their structural similarities to normal structures (e.g., vasculature). We propose a BM-detection framework using a single-sequence gadolinium-enhanced T1-weighted 3D MRI dataset. The framework focuses on detection of smaller (< 15 mm) BM lesions and consists of: (1) candidate-selection stage, using Laplacian of Gaus…
All Sizes Matter: Improving Volumetric Brain Segmentation on Small Lesions
Technical University of Munich（慕尼黑工业大学）；Klinikum rechts der Isar（伊萨尔河右岸医院）；Deutsches Konsortium für Translationale Krebsforschung (DKTK)（德国转化癌症研究联盟（DKTK））；Helmholtz Center Munich（慕尼黑亥姆霍兹中心）
LPIXEL Inc.（LPIXEL公司）；University of Cambridge（剑桥大学）；National Institute of Informatics（国立信息学研究所）；National Center for Global Health and Medicine（国立国际医疗研究中心）；Juntendo University（顺天堂大学）；ELTE Eötvös Loránd University（厄特沃什·罗兰大学）；The University of Tokyo（东京大学）
Unsupervised learning can discover various unseen abnormalities, relying on large-scale unannotated medical images of healthy subjects. Towards this, unsupervised methods reconstruct a 2D/3D single medical image to detect outliers either in the learned feature space or from high reconstruction loss. However, without considering continuity between multiple adjacent slices, they cannot directly discriminate diseases composed of the accumulation of subtle anatomical anomalies, such as Alzheimer's Disease (AD). Moreover, no study has shown how unsupervised anomaly detection is associated with eith…
Adaptable Segmentation Pipeline for Diverse Brain Tumors with Radiomic-Guided Subtyping and Lesion-Wise Model Ensemble
Sheikh Zayed Institute for Pediatric Surgical Innovation（Sheikh Zayed儿童外科创新研究所）；Children’s National Hospital（儿童医院）；University of Washington（华盛顿大学）；Universidad Politécnica de Madrid（马德里理工大学）；CIBER-BBN；ISCIII；School of Medicine and Health Sciences（医学与健康科学学院）
Model Ensemble for Brain Tumor Segmentation in Magnetic Resonance Imaging
Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Hospital（谢赫·扎耶德儿科外科创新研究所，儿童国家医院）；CIBER-BBN, ISCIII（西班牙生物医学研究中心-生物工程、生物材料与纳米医学分部，卡洛斯三世卫生研究所）；Princeton University（普林斯顿大学）；School of Medicine and Health Sciences, George Washington University（乔治·华盛顿大学医学与健康科学学院）
Medical Faculty Mannheim of Heidelberg University（海德堡大学曼海姆医学院）
Statistical analysis of magnetic resonance imaging (MRI) can help radiologists to detect pathologies that are otherwise likely to be missed. Deep learning (DL) has shown promise in modeling complex spatial data for brain anomaly detection. However, DL models have major deficiencies: they need large amounts of high-quality training data, are difficult to design and train and are sensitive to subtle changes in scanning protocols and hardware. Here, we show that also simple statistical methods such as voxel-wise (baseline and covariance) models and a linear projection method using spatial pattern…
Otto von Guericke University Magdeburg（奥托·冯·格里克马格德堡大学）；Center for Behavioral Brain Sciences（行为脑科学中心）；German Center for Neurodegenerative Disease（德国神经退行性疾病中心）；Leibniz Institute for Neurobiology（莱布尼茨神经生物学研究所）
A brain tumour is a mass or cluster of abnormal cells in the brain, which has the possibility of becoming life-threatening because of its ability to invade neighbouring tissues and also form metastases. An accurate diagnosis is essential for successful treatment planning and magnetic resonance imaging is the principal imaging modality for diagnostic of brain tumours and their extent. Deep Learning methods in computer vision applications have shown significant improvement in recent years, most of which can be credited to the fact that a sizeable amount of data is available to train models on, a…
Preoperative brain tumor imaging: models and software for segmentation and standardized reporting
SINTEF Digital（挪威科技工业研究院数字研究所）；Norwegian University of Science and Technology（挪威科技大学）；St. Olavs hospital, Trondheim University Hospital（特隆赫姆大学医院圣奥拉夫医院）；Sahlgrenska University Hospital（萨尔格伦斯卡大学医院）；Sahlgrenska Academy, University of Gothenburg（哥德堡大学萨尔格伦斯卡学院）；Oslo University Hospital（奥斯陆大学医院）；Amsterdam University Medical Centers, Vrije Universiteit（阿姆斯特丹自由大学阿姆斯特丹大学医学中心）；Cancer Center Amsterdam, Brain Tumor Center, Amsterdam University Medical Centers（阿姆斯特丹大学医学中心阿姆斯特丹癌症中心脑肿瘤中心）
Skolkovo Institute of Science and Technology（斯科尔科沃科学技术学院）；Kharkevich Institute for Information Transmission Problems（哈尔克维奇信息传输问题研究所）；Moscow Institute of Physics and Technology（莫斯科物理技术学院）；Higher School of Economics（高等经济学院）；Moscow Gamma-Knife Center（莫斯科伽马刀中心）；Burdenko Neurosurgery Institute（布尔坚科神经外科研究所）
Target imbalance affects the performance of recent deep learning methods in many medical image segmentation tasks. It is a twofold problem: class imbalance - positive class (lesion) size compared to negative class (non-lesion) size; lesion size imbalance - large lesions overshadows small ones (in the case of multiple lesions per image). While the former was addressed in multiple works, the latter lacks investigation. We propose a loss reweighting approach to increase the ability of the network to detect small lesions. During the learning process, we assign a weight to every image voxel. The as…
