Purpose: White-matter tract segmentation in patients with brain pathology can guide surgical planning and can be used for tissue integrity assessment. Recently, TractSeg was proposed for automatic ...tract segmentation in healthy subjects. The aim of this study was to assess the use of TractSeg for corticospinal-tract (CST) segmentation in a large cohort of patients with brain pathology and to evaluate its consistency in repeated measurements. Methods: A total of 649 diffusion-tensor-imaging scans were included, of them: 625 patients and 24 scans from 12 healthy controls (scanned twice for consistency assessment). Manual CST labeling was performed in all cases, and by 2 raters for the healthy subjects. Segmentation results were evaluated based on the Dice score. In order to evaluate consistency in repeated measurements, volume, Fractional Anisotropy (FA), and Mean Diffusivity (MD) values were extracted and correlated for the manual versus automatic methods. Results: For the automatic CST segmentation Dice scores of 0.63 and 0.64 for the training and testing datasets were obtained. Higher consistency between measurements was detected for the automatic segmentation, with between measurements correlations of volume = 0.92/0.65, MD = 0.94/0.75 for the automatic versus manual segmentation. Conclusions: The TractSeg method enables automatic CST segmentation in patients with brain pathology. Superior measurements consistency was detected for the automatic in comparison to manual fiber segmentation, which indicates an advantage when using this method for clinical and longitudinal studies.
Normal fetal adipose tissue (AT) development is essential for perinatal well-being. AT, or simply fat, stores energy in the form of lipids. Malnourishment may result in excessive or depleted ...adiposity. Although previous studies showed a correlation between the amount of AT and perinatal outcome, prenatal assessment of AT is limited by lacking quantitative methods. Using magnetic resonance imaging (MRI), 3D fat- and water-only images of the entire fetus can be obtained from two point Dixon images to enable AT lipid quantification. This paper is the first to present a methodology for developing a deep learning based method for fetal fat segmentation based on Dixon MRI. It optimizes radiologists' manual fetal fat delineation time to produce annotated training dataset. It consists of two steps: 1) model-based semi-automatic fetal fat segmentations, reviewed and corrected by a radiologist; 2) automatic fetal fat segmentation using DL networks trained on the resulting annotated dataset. Three DL networks were trained. We show a significant improvement in segmentation times (3:38 hours to < 1 hour) and observer variability (Dice of 0.738 to 0.906) compared to manual segmentation. Automatic segmentation of 24 test cases with the 3D Residual U-Net, nn-UNet and SWIN-UNetR transformer networks yields a mean Dice score of 0.863, 0.787 and 0.856, respectively. These results are better than the manual observer variability, and comparable to automatic adult and pediatric fat segmentation. A radiologist reviewed and corrected six new independent cases segmented using the best performing network, resulting in a Dice score of 0.961 and a significantly reduced correction time of 15:20 minutes. Using these novel segmentation methods and short MRI acquisition time, whole body subcutaneous lipids can be quantified for individual fetuses in the clinic and large-cohort research.
