Automatic Tissue Segmentation with Deep Learning in Patients with Congenital or Acquired Distortion of Brain Anatomy

Brains with complex distortion of cerebral anatomy present several challenges to automatic tissue segmentation methods of T1-weighted MR images. First, the very high variability in the morphology of the tissues can be incompatible with the prior knowledge embedded within the algorithms. Second, the availability of MR images of distorted brains is very scarce, so the methods in the literature have not addressed such cases so far. In this work, we present the first evaluation of state-of-the-art automatic tissue segmentation pipelines on T1-weighted images of brains with different severity of congenital or acquired brain distortion. We compare traditional pipelines and a deep learning model, i.e. a 3D U-Net trained on normal-appearing brains. Unsurprisingly, traditional pipelines completely fail to segment the tissues with strong anatomical distortion. Surprisingly, the 3D U-Net provides useful segmentations that can be a valuable starting point for manual refinement by experts/neuroradiologists.