Automated deep learning–based segmentation and volumetric analysis of meningiomas

INTRODUCTION: Meningiomas are the most common primary intracranial tumors and are frequently monitored over extended periods. Volumetric assessment typically requires manual segmentation, which is time-consuming and associated with interrater variability. This study aimed to develop and validate a deep learning-based model for the automated segmentation of meningiomas and associated peritumoral edema on preoperative magnetic resonance imaging (MRI). METHODS: We trained a standard nnU-Net deep learning model on contrast-enhanced T1-weighted and FLAIR MRI scans from 100 patients treated at the University Hospital of Zurich. The model was then externally validated on 88 cases from the meningioma SEG-Class dataset from the Cancer Imaging Archive. Segmentation performance was assessed using the Dice similarity coefficient, Jaccard index, and 95th percentile Hausdorff distance. RESULTS: The model achieved mean Dice scores of 0.87 ± 0.23 for meningioma segmentation and 0.63 ± 0.38 for peritumoral edema in internal cross-validation. On the external validation set, the model achieved scores of 0.86 ± 0.17 for meningioma segmentation and 0.31 ± 0.35 for edema. CONCLUSION: The deep learning model demonstrated high accuracy in segmenting meningiomas and modest performance for peritumoral edema. These results support the potential utility of automated segmentation tools in clinical workflows. Future work should focus on validating model performance across larger multi-center datasets.