Exploring Multi-Pathology Brain Segmentation: From Volume-Based to Component-Based Deep Learning Analysis

Detection and segmentation of brain abnormalities using Magnetic Resonance Imaging (MRI) is an important task that, nowadays, the role of AI algorithms as supporting tools is well established both at the research and clinical-production level. While the performance of the state-of-the-art models is increasing, reaching radiologists and other experts' accuracy levels in many cases, there is still a lot of research needed on the direction of in-depth and transparent evaluation of the correct results and failures, especially in relation to important aspects of the radiological practice: abnormality position, intensity level, and volume. In this work, we focus on the analysis of the segmentation results of a pre-trained U-net model trained and validated on brain MRI examinations containing four different pathologies: Tumors, Strokes, Multiple Sclerosis (MS), and White Matter Hyperintensities (WMH). We present the segmentation results for both the whole abnormal volume and for each abnormal component inside the examinations of the validation set. In the first case, a dice score coefficient (DSC), sensitivity, and precision of 0.76, 0.78, and 0.82, respectively, were found, while in the second case the model detected and segmented correct (True positives) the 48.8% (DSC ≥ 0.5) of abnormal components, partially correct the 27.1% (0.05 > DSC > 0.5), and missed (False Negatives) the 24.1%, while it produced 25.1% False Positives. Finally, we present an extended analysis between the True positives, False Negatives, and False positives versus their position inside the brain, their intensity at three MRI modalities (FLAIR, T2, and T1ce) and their volume.