DCEF-AVNet: multi-scale feature fusion and attention mechanism-guided brain tumor segmentation network.

To develop a novel method based on feature selection, combining convolutional neural network (CNN) and ensemble learning (EL), to achieve high accuracy and efficiency of glioma detection and segmentation using multiparametric MRIs. We proposed an evolutionary feature selection-based hybrid approach for glioma detection and segmentation on 4MR sequences (T2-FLAIR, T1, T1Gd, and T2). First, we trained a lightweight CNN to detect glioma and mask the suspected region to process large batch of MRI images. Second, we employed a differential evolution algorithm to search a feature space, which composed of 416-dimensions radiomics features extracted from four sequences of MRIs and 128-dimensions high-order features extracted by the CNN, to generate an optimal feature combination for pixel classification. Finally, we trained an EL classifier using the optimal feature combination to segment whole tumor (WT) and its subregions including non-enhancing tumor (NET), peritumoral edema (ED), and enhancing tumor (ET) in the suspected region. Experiments were carried out on 300 glioma patients from the BraTS2019 dataset using fivefold cross-validation, and the model was independently validated using the rest 35 patients from the same database. The approach achieved a detection accuracy of 98.8% using four MRIs. The Dice coefficients (and standard deviations) were 0.852±0.057, 0.844±0.046, and 0.799±0.053 for segmentation of WT (NET+ET+ED), tumor core (NET+ET), and ET, respectively. The sensitivities and specificities were 0.873±0.074, 0.863±0.072, and 0.852±0.082; the specificities were 0.994±0.005, 0.994±0.005, and 0.995±0.004 for the WT, tumor core, and ET, respectively. The performances and calculation times were compared with the state-of-the-art approaches, our approach yielded a better overall performance with average processing time of 139.5s per set of four sequence MRIs. We demonstrated a robust and computational cost-effective hybrid segmentation approach for glioma and its subregions on multi-sequence MR images. The proposed approach can be used for automated target delineation for glioma patients.

CLCU-Net: Cross-level connected U-shaped network with selective feature aggregation attention module for brain tumor segmentation

Gliomas, the most aggressive primary tumors in the central nervous system, are characterized by high morphological heterogeneity and diffusely infiltrating boundaries. Such complexity poses significant challenges for accurate segmentation in clinical practice. Although deep learning methods have shown promising results, they often struggle to achieve a satisfactory trade-off among precise boundary delineation, robust multi-scale feature representation, and computational efficiency, particularly when processing high-resolution three-dimensional (3D) magnetic resonance imaging (MRI) data. Therefore, the aim of this study is to develop a novel 3D segmentation framework that specifically addresses these challenges, thereby improving clinical utility in brain tumor analysis. To accomplish this, we propose a multi-level channel-spatial attention and light-weight scale-fusion network (MCSLF-Net), which integrates a multi-level channel-spatial attention mechanism (MCSAM) and a light-weight scale-fusion module. By strategically enhancing subtle boundary features while maintaining a compact network design, our approach seeks to achieve high accuracy in delineating complex glioma morphologies, reduce computational burden, and provide a more clinically feasible segmentation solution. We propose MCSLF-Net, a network integrating two key components: (I) MCSAM: by strategically inserting a 3D channel-spatial attention module at critical semantic layers, the network progressively emphasizes subtle, infiltrative edges and small, easily overlooked contours. This avoids reliance on an additional edge detection branch while enabling fine-grained localization in ambiguous transitional regions. (II) Light-weight scale fusion unit (LSFU): leveraging depth-wise separable convolutions combined with multi-scale atrous (dilated) convolutions, LSFU enhances computational efficiency and adapts to varying feature requirements at different network depths. In doing so, it effectively captures small infiltrative lesions as well as extensive tumor areas. By coupling these two modules, MCSLF-Net balances global contextual information with local fine-grained features, simultaneously reducing the computational burden typically associated with 3D medical image segmentation. Extensive experiments on the BraTS 2019, BraTS 2020, and BraTS 2021 datasets validated the effectiveness of our approach. On BraTS 2021, MCSLF-Net achieved a mean Dice similarity coefficient (DSC) of 0.8974 and a mean 95th percentile Hausdorff distance (HD95) of 2.52 mm. Notably, it excels in segmenting intricate transitional areas, including the enhancing tumor (ET) region and the tumor core (TC), thereby demonstrating superior boundary delineation and multi-scale feature fusion capabilities relative to existing methods. These findings underscore the clinical potential of deploying multi-level channel-spatial attention and light-weight multi-scale fusion strategies in high-precision 3D glioma segmentation. By striking an optimal balance among boundary accuracy, multi-scale feature capture, and computational efficiency, the proposed MCSLF-Net offers a practical framework for further advancements in automated brain tumor analysis and can be extended to a range of 3D medical image segmentation tasks.

GCAUNet: A group cross-channel attention residual UNet for slice based brain tumor segmentation

A deep convolutional neural network (CNN) achieves remarkable performance for medical image analysis. UNet is the primary source in the performance of 3D CNN architectures for medical imaging tasks, including brain tumor segmentation. The skip connection in the UNet architecture concatenates multi-scale features from image data. The multi-scaled features play an essential role in brain tumor segmentation. Researchers presented numerous multi-scale strategies that have been excellent for the segmentation task. This paper proposes a multi-scale strategy that can further improve the final segmentation accuracy. We propose three multi-scale strategies in MS UNet. Firstly, we utilize densely connected blocks in the encoder and decoder for multi-scale features. Next, the proposed residual-inception blocks extract local and global information by merging features of different kernel sizes. Lastly, we utilize the idea of deep supervision for multiple depths at the decoder. We validate the MS UNet on the BraTS 2021 validation dataset. The dice (DSC) scores of the whole tumor (WT), tumor core (TC), and enhancing tumor (ET) are \(91.938\%\), \(86.268\%\), and \(82.409\%\), respectively.KeywordsCNNUNetContextual informationDense connectionsResidual inception blocksBrain tumor segmentation

Gliomas are the most common and aggressive form of all brain tumors, with medial survival rates of less than two years for the highest grade. While accurate and reproducible segmentation of brain tumors is paramount for an effective treatment plan and diagnosis, automatic brain tumor segmentation is challenging because the lesion can appear anywhere in the brain with varying shapes and sizes from one patient to another. Moreover, segmentation is only done by analyzing pixel intensity values of surrounding tissues, and the diffusing nature of aggressive brain tumors makes it even more challenging to delineate tumor boundaries. Nevertheless, deep learning methods have superior performance in automatic brain tumor segmentation. However, their boost in performance comes at the cost of high computational complexity. This paper proposes efficient network architecture for 3D brain tumor segmentation, partially utilizing depthwise separable convolutions to reduce computational costs. The experimental results on the BraTS 2020 dataset show that our methods could achieve comparable results with the state-of-the-art methods with minimum computational complexity. Furthermore, we provide a critical analysis of the current efficient model designs. The code for this project is available at https://github.com/tmagadza/partialDepthwiseNet.

The fully convolutional networks (FCNs) have been widely applied in numerous medical image segmentation tasks. However, tissue regions usually have large variations of shape and scale, so the ability of neural networks to learn multi-scale features is important to the segmentation performance. In this paper, we improve the network for multi-scale feature fusion, in the medical image segmentation by introducing two feature fusion modules: i) global attention multi-scale feature fusion module (GMF); ii) local dense multi-scale feature fusion module (LMF). GMF aims to use global context information to guide the recalibration of low-level features from both spatial and channel aspects, so as to enhance the utilization of effective multi-scale features and suppress the noise of low-level features. LMF adopts bottom-up top-down structure to capture context information, to generate semantic features, and to fuse feature information at different scales. LMF can integrate local dense multi-scale context features layer by layer in the network, thus improving the ability of network to encode interdependent relationships among boundary pixels. Based on the above two modules, we propose a novel medical image segmentation framework (GLF-Net). We evaluated the proposed network and modules on challenging brain tumor segmentation and pancreas segmentation datasets, and very competitive performance has been achieved.

We developed a fully automated method for brain tumor segmentation using deep learning; 285 brain tumor cases with multiparametric magnetic resonance images from the BraTS2018 data set were used. We designed 3 separate 3D-Dense-UNets to simplify the complex multiclass segmentation problem into individual binary-segmentation problems for each subcomponent. We implemented a 3-fold cross-validation to generalize the network's performance. The mean cross-validation Dice-scores for whole tumor (WT), tumor core (TC), and enhancing tumor (ET) segmentations were 0.92, 0.84, and 0.80, respectively. We then retrained the individual binary-segmentation networks using 265 of the 285 cases, with 20 cases held-out for testing. We also tested the network on 46 cases from the BraTS2017 validation data set, 66 cases from the BraTS2018 validation data set, and 52 cases from an independent clinical data set. The average Dice-scores for WT, TC, and ET were 0.90, 0.84, and 0.80, respectively, on the 20 held-out testing cases. The average Dice-scores for WT, TC, and ET on the BraTS2017 validation data set, the BraTS2018 validation data set, and the clinical data set were as follows: 0.90, 0.80, and 0.78; 0.90, 0.82, and 0.80; and 0.85, 0.80, and 0.77, respectively. A fully automated deep learning method was developed to segment brain tumors into their subcomponents, which achieved high prediction accuracy on the BraTS data set and on the independent clinical data set. This method is promising for implementation into a clinical workflow.

Currently, brain tumors are extremely harmful and prevalent. Deep learning technologies, including CNNs, UNet, and Transformer, have been applied in brain tumor segmentation for many years and have achieved some success. However, traditional CNNs and UNet capture insufficient global information, and Transformer cannot provide sufficient local information. Fusing the global information from Transformer with the local information of convolutions is an important step toward improving brain tumor segmentation. We propose the Group Normalization Shuffle and Enhanced Channel Self-Attention Network (GETNet), a network combining the pure Transformer structure with convolution operations based on VT-UNet, which considers both global and local information. The network includes the proposed group normalization shuffle block (GNS) and enhanced channel self-attention block (ECSA). The GNS is used after the VT Encoder Block and before the downsampling block to improve information extraction. An ECSA module is added to the bottleneck layer to utilize the characteristics of the detailed features in the bottom layer effectively. We also conducted experiments on the BraTS2021 dataset to demonstrate the performance of our network. The Dice coefficient (Dice) score results show that the values for the regions of the whole tumor (WT), tumor core (TC), and enhancing tumor (ET) were 91.77, 86.03, and 83.64, respectively. The results show that the proposed model achieves state-of-the-art performance compared with more than eleven benchmarks.

Aim: Brain tumors are among the most fatal cancers worldwide. Diagnosing and manually segmenting tumors are time-consuming clinical tasks, and success strongly depends on the doctor's experience. Automatic quantitative analysis and accurate segmentation of brain tumors are greatly needed for cancer diagnosis.Methods:This paper presents an advanced three-dimensional multimodal segmentation algorithm called nested dilation networks (NDNs). It is inspired by the U-Net architecture, a convolutional neural network (CNN) developed for biomedical image segmentation and is modified to achieve better performance for brain tumor segmentation. Thus, we propose residual blocks nested with dilations (RnD) in the encoding part to enrich the low-level features and use squeeze-and-excitation (SE) blocks in both the encoding and decoding parts to boost significant features. To prove the reliability of the network structure, we compare our results with those of the standard U-Net and its transmutation networks. Different loss functions are considered to cope with class imbalance problems to maximize the brain tumor segmentation results. A cascade training strategy is employed to run NDNs for coarse-to-fine tumor segmentation. This strategy decomposes the multiclass segmentation problem into three binary segmentation problems and trains each task sequentially. Various augmentation techniques are utilized to increase the diversity of the data to avoid overfitting.Results: This approach achieves Dice similarity scores of 0.6652, 0.5880, and 0.6682 for edema, non-enhancing tumors, and enhancing tumors, respectively, in which the Dice loss is used for single-pass training. After cascade training, the Dice similarity scores rise to 0.7043, 0.5889, and 0.7206, respectively.Conclusion: Experiments show that the proposed deep learning algorithm outperforms other U-Net transmutation networks for brain tumor segmentation. Moreover, applying cascade training to NDNs facilitates better performance than other methods. The findings of this study provide considerable insight into the automatic and accurate segmentation of brain tumors.

For patients with brain tumors, effectively utilizing the complementary information between multimodal medical images is crucial for accurate lesion segmentation. However, effectively utilizing the complementary features across different modalities remains a challenging task. To address these challenges, we propose a modal feature supplement network (MFSNet), which extracts modality features simultaneously using both a main and an auxiliary network. During this process, the auxiliary network supplements the modality features of the main network, enabling accurate brain tumor segmentation. We also design a modal feature enhancement module (MFEM), a cross‐layer feature fusion module (CFFM), and an edge feature supplement module (EFSM). MFEM enhances the network performance by fusing the modality features from the main and auxiliary networks. CFFM supplements additional contextual information by fusing features from adjacent encoding layers at different scales, which are then passed into the corresponding decoding layers. This aids the network in preserving more details during upsampling. EFSM improves network performance by using deformable convolution to extract challenging boundary lesion features, which are then used to supplement the final output of the decoding layer. We evaluated MFSNet on the BraTS2018 and BraTS2021 datasets. The Dice scores for the whole tumor, tumor core, and enhancing tumor regions were 90.86%, 90.59%, 84.72%, and 92.28%, 92.47%, 86.07%, respectively. This validates the accuracy of MFSNet in brain tumor segmentation, demonstrating its superiority over other networks of similar type.

Accurate brain tumor segmentation is crucial for clinical assessment, follow-up, and subsequent treatment of gliomas. While convolutional neural networks (CNN) have become state of the art in this task, most proposed models either use 2D architectures ignoring 3D contextual information or 3D models requiring large memory capacity and extensive learning databases. In this study, an ensemble of two kinds of U-Net-like models based on both 3D and 2.5D convolutions is proposed to segment multimodal magnetic resonance images (MRI). The 3D model uses concatenated data in a modified U-Net architecture. In contrast, the 2.5D model is based on a multi-input strategy to extract low-level features from each modality independently and on a new 2.5D Multi-View Inception block that aims to merge features from different views of a 3D image aggregating multi-scale features. The Asymmetric Ensemble of Asymmetric U-Net (AE AU-Net) based on both is designed to find a balance between increasing multi-scale and 3D contextual information extraction and keeping memory consumption low. Experiments on 2019 dataset show that our model improves enhancing tumor sub-region segmentation. Overall, performance is comparable with state-of-the-art results, although with less learning data or memory requirements. In addition, we provide voxel-wise and structure-wise uncertainties of the segmentation results, and we have established qualitative and quantitative relationships between uncertainty and prediction errors. Dice similarity coefficient for the whole tumor, tumor core, and tumor enhancing regions on BraTS 2019 validation dataset were 0.902, 0.815, and 0.773. We also applied our method in BraTS 2018 with corresponding Dice score values of 0.908, 0.838, and 0.800.

An automatic segmentation of brain tumors from medical images is significant for diagnosis and treatment planning. Magnetic resonance imaging (MRI) is widely used by surgeons, radiologists, and medical specialists for brain segmentation. To enhance the reliability and security of the segmentation process, this study introduces a blockchain‐based Recursive Residual Blocks and Pyramid Pooling Segmentation Network (RP‐Segnet) for brain tumor segmentation using MRI. In the proposed framework, blockchain technology is employed to ensure the integrity and traceability of the parameters of the model by encrypting and verifying layer‐specific data, such as weights and biases. This prevents unauthorized tampering and enables secure handling of model data, thereby supporting robust and trustworthy segmentation. Initially, input MRI is acquired from the dataset and is transferred to the preprocessing step, wherein the unwanted images are eliminated by employing Gaussian filtering. Once the preprocessing is completed, the brain image is transferred to the brain tumor segmentation module, which separates the tumor region from the background of the tumor image, which is performed using the proposed RP‐Segnet. The RP‐Segnet is designed by the formation of Recursive residual blocks and a Pyramid pooling Network (RP‐Net) and Segmentation Network (SegNet). Moreover, the efficacy of the proposed RP‐Segnet for brain tumor segmentation is determined based on evaluation measures, such as segmentation accuracy, dice coefficient, and Jaccard similarity, and it has attained maximal values of 92.04%, 95.07%, and 95.03%.

Intraoperative ultrasound (iUS) is increasingly used in pediatric brain tumor surgery. However, accurate tumor tissue identification and localization within the patient with iUS remains challenging. Automatic tumor segmentation may overcome these difficulties by providing quicker, more consistent, and reliable image analysis. This study evaluated the feasibility of automatic 3-dimensional segmentation of pediatric brain tumors using navigated iUS. A retrospective analysis was conducted on 109 navigated iUS acquisitions from 60 pediatric patients who underwent neurosurgical tumor resection. 3-dimensional nnU-Net was trained on 79 preresectional iUS acquisitions with corresponding tumor segmentations. Evaluation was performed on 30 iUS acquisitions against segmentations validated by 2 neurosurgeons. Performance benchmarks were set at a minimum Dice Similarity Coefficient (DSC) of 0.85 and a maximum mean surface distance and 95th percentile Hausdorff distance of 5 mm. The trained algorithm predicted tumor segmentations for all acquisitions in the test set, which met the predefined benchmark values with a median DSC of 0.89 (IQR: 0.13), a median mean surface distance of 1.1 mm (IQR: 1.0 mm), and a median 95th percentile Hausdorff distance of 5.6 mm (IQR: 3.5 mm). The lowest quartile of DSC values consisted of 5 patients, including craniopharyngiomas (n = 3) and high-grade gliomas (n = 2). Oversegmentation of the lateral ventricle as tumor was observed in 2 patients. In 1 high-grade glioma case, edema was misclassified as tumor because of unclear tumor boundaries. This study demonstrates that automatic segmentation of pediatric brain tumors using navigated iUS is feasible and achieved high performance in most cases, with few outliers that showed moderate performance in tumor prediction. Future efforts will focus on real-time segmentation of residual tumor tissue during tumor resection. Ultimately, real-time visualization of automatically segmented tumors in 3 dimensions could improve intraoperative navigation and support neurosurgical decision making.

Application of the bicharacteristic attention residual pyramid for the treatment of brain tumors