Model Ensemble for Brain Tumor Segmentation in Magnetic Resonance Imaging

Segmenting brain tumors in multi-parametric magnetic resonance imaging enables performing quantitative analysis in support of clinical trials and personalized patient care. This analysis provides the potential to impact clinical decision-making processes, including diagnosis and prognosis. In 2023, the well-established Brain Tumor Segmentation (BraTS) challenge presented a substantial expansion with eight tasks and 4,500 brain tumor cases. In this paper, we present a deep learning-based ensemble strategy that is evaluated for newly included tumor cases in three tasks: pediatric brain tumors (PED), intracranial meningioma (MEN), and brain metastases (MET). In particular, we ensemble outputs from state-of-the-art nnU-Net and Swin UNETR models on a region-wise basis. Furthermore, we implemented a targeted post-processing strategy based on a cross-validated threshold search to improve the segmentation results for tumor sub-regions. The evaluation of our proposed method on unseen test cases for the three tasks resulted in lesion-wise Dice scores for PED: 0.653, 0.809, 0.826; MEN: 0.876, 0.867, 0.849; and MET: 0.555, 0.6, 0.58; for the enhancing tumor, tumor core, and whole tumor, respectively. Our method was ranked first for PED, third for MEN, and fourth for MET, respectively.

Data Alchemy: Mitigating Cross-Site Model Variability Through Test Time Data Calibration

Deploying deep learning-based imaging tools across various clinical sites poses significant challenges due to inherent domain shifts and regulatory hurdles associated with site-specific fine-tuning. For histopathology, stain normalization techniques can mitigate discrepancies, but they often fall short of eliminating inter-site variations. Therefore, we present Data Alchemy, an explainable stain normalization method combined with test time data calibration via a template learning framework to overcome barriers in cross-site analysis. Data Alchemy handles shifts inherent to multi-site data and minimizes them without needing to change the weights of the normalization or classifier networks. Our approach extends to unseen sites in various clinical settings where data domain discrepancies are unknown. Extensive experiments highlight the efficacy of our framework in tumor classification in hematoxylin and eosin-stained patches. Our explainable normalization method boosts classification tasks' area under the precision-recall curve(AUPR) by 0.165, 0.545 to 0.710. Additionally, Data Alchemy further reduces the multisite classification domain gap, by improving the 0.710 AUPR an additional 0.142, elevating classification performance further to 0.852, from 0.545. Our Data Alchemy framework can popularize precision medicine with minimal operational overhead by allowing for the seamless integration of pre-trained deep learning-based clinical tools across multiple sites.