The 2024 Brain Tumor Segmentation (BraTS) Challenge: Glioma Segmentation on Post-treatment MRI

Gliomas are the most common malignant primary brain tumors in adults and one of the deadliest types of cancer. There are many challenges in treatment and monitoring due to the genetic diversity and high intrinsic heterogeneity in appearance, shape, histology, and treatment response. Treatments include surgery, radiation, and systemic therapies, with magnetic resonance imaging (MRI) playing a key role in treatment planning and post-treatment longitudinal assessment. The 2024 Brain Tumor Segmentation (BraTS) challenge on post-treatment glioma MRI will provide a community standard and benchmark for state-of-the-art automated segmentation models based on the largest expert-annotated post-treatment glioma MRI dataset. Challenge competitors will develop automated segmentation models to predict four distinct tumor sub-regions consisting of enhancing tissue (ET), surrounding non-enhancing T2/fluid-attenuated inversion recovery (FLAIR) hyperintensity (SNFH), non-enhancing tumor core (NETC), and resection cavity (RC). Models will be evaluated on separate validation and test datasets using standardized performance metrics utilized across the BraTS 2024 cluster of challenges, including lesion-wise Dice Similarity Coefficient and Hausdorff Distance. Models developed during this challenge will advance the field of automated MRI segmentation and contribute to their integration into clinical practice, ultimately enhancing patient care.

Analysis of the BraTS 2023 Intracranial Meningioma Segmentation Challenge

We describe the design and results from the BraTS 2023 Intracranial Meningioma Segmentation Challenge. The BraTS Meningioma Challenge differed from prior BraTS Glioma challenges in that it focused on meningiomas, which are typically benign extra-axial tumors with diverse radiologic and anatomical presentation and a propensity for multiplicity. Nine participating teams each developed deep-learning automated segmentation models using image data from the largest multi-institutional systematically expert annotated multilabel multi-sequence meningioma MRI dataset to date, which included 1000 training set cases, 141 validation set cases, and 283 hidden test set cases. Each case included T2, T2/FLAIR, T1, and T1Gd brain MRI sequences with associated tumor compartment labels delineating enhancing tumor, non-enhancing tumor, and surrounding non-enhancing T2/FLAIR hyperintensity. Participant automated segmentation models were evaluated and ranked based on a scoring system evaluating lesion-wise metrics including dice similarity coefficient (DSC) and 95% Hausdorff Distance. The top ranked team had a lesion-wise median dice similarity coefficient (DSC) of 0.976, 0.976, and 0.964 for enhancing tumor, tumor core, and whole tumor, respectively and a corresponding average DSC of 0.899, 0.904, and 0.871, respectively. These results serve as state-of-the-art benchmarks for future pre-operative meningioma automated segmentation algorithms. Additionally, we found that 1286 of 1424 cases (90.3%) had at least 1 compartment voxel abutting the edge of the skull-stripped image edge, which requires further investigation into optimal pre-processing face anonymization steps.

The Brain Tumor Segmentation Challenge 2023: Brain MR Image Synthesis for Tumor Segmentation

Automated brain tumor segmentation methods are well established, reaching performance levels with clear clinical utility. Most algorithms require four input magnetic resonance imaging (MRI) modalities, typically T1-weighted images with and without contrast enhancement, T2-weighted images, and FLAIR images. However, some of these sequences are often missing in clinical practice, e.g., because of time constraints and/or image artifacts (such as patient motion). Therefore, substituting missing modalities to recover segmentation performance in these scenarios is highly desirable and necessary for the more widespread adoption of such algorithms in clinical routine. In this work, we report the set-up of the Brain MR Image Synthesis Benchmark (BraSyn), organized in conjunction with the Medical Image Computing and Computer-Assisted Intervention (MICCAI) 2023. The objective of the challenge is to benchmark image synthesis methods that realistically synthesize missing MRI modalities given multiple available images to facilitate automated brain tumor segmentation pipelines. The image dataset is multi-modal and diverse, created in collaboration with various hospitals and research institutions.

The Brain Tumor Segmentation Challenge 2023: Local Synthesis of Healthy Brain Tissue via Inpainting

A myriad of algorithms for the automatic analysis of brain MR images is available to support clinicians in their decision-making. For brain tumor patients, the image acquisition time series typically starts with a scan that is already pathological. This poses problems, as many algorithms are designed to analyze healthy brains and provide no guarantees for images featuring lesions. Examples include but are not limited to algorithms for brain anatomy parcellation, tissue segmentation, and brain extraction. To solve this dilemma, we introduce the BraTS 2023 inpainting challenge. Here, the participants' task is to explore inpainting techniques to synthesize healthy brain scans from lesioned ones. The following manuscript contains the task formulation, dataset, and submission procedure. Later it will be updated to summarize the findings of the challenge. The challenge is organized as part of the BraTS 2023 challenge hosted at the MICCAI 2023 conference in Vancouver, Canada.

The University of California San Francisco Preoperative Diffuse Glioma MRI Dataset

Here we present the University of California San Francisco Preoperative Diffuse Glioma MRI (UCSF-PDGM) dataset. The UCSF-PDGM dataset includes 500 subjects with histopathologically-proven diffuse gliomas who were imaged with a standardized 3 Tesla preoperative brain tumor MRI protocol featuring predominantly 3D imaging, as well as advanced diffusion and perfusion imaging techniques. The dataset also includes isocitrate dehydrogenase (IDH) mutation status for all cases and O6-methylguanine-DNA methyltransferase (MGMT) promotor methylation status for World Health Organization (WHO) grade III and IV gliomas. The UCSF-PDGM has been made publicly available in the hopes that researchers around the world will use these data to continue to push the boundaries of AI applications for diffuse gliomas.

The RSNA-ASNR-MICCAI BraTS 2021 Benchmark on Brain Tumor Segmentation and Radiogenomic Classification

The BraTS 2021 challenge celebrates its 10th anniversary and is jointly organized by the Radiological Society of North America (RSNA), the American Society of Neuroradiology (ASNR), and the Medical Image Computing and Computer Assisted Interventions (MICCAI) society. Since its inception, BraTS has been focusing on being a common benchmarking venue for brain glioma segmentation algorithms, with well-curated multi-institutional multi-parametric magnetic resonance imaging (mpMRI) data. Gliomas are the most common primary malignancies of the central nervous system, with varying degrees of aggressiveness and prognosis. The RSNA-ASNR-MICCAI BraTS 2021 challenge targets the evaluation of computational algorithms assessing the same tumor compartmentalization, as well as the underlying tumor's molecular characterization, in pre-operative baseline mpMRI data from 2,000 patients. Specifically, the two tasks that BraTS 2021 focuses on are: a) the segmentation of the histologically distinct brain tumor sub-regions, and b) the classification of the tumor's O[6]-methylguanine-DNA methyltransferase (MGMT) promoter methylation status. The performance evaluation of all participating algorithms in BraTS 2021 will be conducted through the Sage Bionetworks Synapse platform (Task 1) and Kaggle (Task 2), concluding in distributing to the top ranked participants monetary awards of $60,000 collectively.