Magnetic resonance image-based brain tumour segmentation methods: A systematic review

Abstract

Background: Image segmentation is an essential step in the analysis and subsequent characterisation of brain tumours through magnetic resonance imaging. In the literature, segmentation methods are empowered by open-access magnetic resonance imaging datasets, such as the brain tumour segmentation dataset. Moreover, with the increased use of artificial intelligence methods in medical imaging, access to larger data repositories has become vital in method development.

Purpose: To determine what automated brain tumour segmentation techniques can medical imaging specialists and clinicians use to identify tumour components, compared to manual segmentation.

Methods: We conducted a systematic review of 572 brain tumour segmentation studies during 2015-2020. We reviewed segmentation techniques using T1-weighted, T2-weighted, gadolinium-enhanced T1-weighted, fluid-attenuated inversion recovery, diffusion-weighted and perfusion-weighted magnetic resonance imaging sequences. Moreover, we assessed physics or mathematics-based methods, deep learning methods, and software-based or semi-automatic methods, as applied to magnetic resonance imaging techniques. Particularly, we synthesised each method as per the utilised magnetic resonance imaging sequences, study population, technical approach (such as deep learning) and performance score measures (such as Dice score).

Statistical tests: We compared median Dice score in segmenting the whole tumour, tumour core and enhanced tumour.

Results: We found that T1-weighted, gadolinium-enhanced T1-weighted, T2-weighted and fluid-attenuated inversion recovery magnetic resonance imaging are used the most in various segmentation algorithms. However, there is limited use of perfusion-weighted and diffusion-weighted magnetic resonance imaging. Moreover, we found that the U-Net deep learning technology is cited the most, and has high accuracy (Dice score 0.9) for magnetic resonance imaging-based brain tumour segmentation.

Conclusion: U-Net is a promising deep learning technology for magnetic resonance imaging-based brain tumour segmentation. The community should be encouraged to contribute open-access datasets so training, testing and validation of deep learning algorithms can be improved, particularly for diffusion- and perfusion-weighted magnetic resonance imaging, where there are limited datasets available.

Keywords: Brain tumour; artificial intelligence; brain; magnetic resonance imaging; segmentation; systematic review.

Figure 1.

PRISMA diagram. PRISMA diagram of the systematic review of brain tumour segmentation methods.

Figure 2.

A number of articles (2015–2020). The bar plot represents the number of articles published over the review period (2015–2020), and pie charts depict published articles in each category of technical method in each corresponding year. Total articles = 223 refers to the articles included for the synthesis.

Figure 3.

Comparison of segmentation results. Performance score evaluation, in segmenting WT, TC and ET, by considering all 223 articles.

Figure 4.

Data samples in deep learning studies. Summary of training, validation and test data samples reported in deep learning methods. Median of training, validation and test data samples are 285, 54 and 110, respectively.