Analysis of the MICCAI Brain Tumor Segmentation -- Metastases (BraTS-METS) 2025 Lighthouse Challenge: Brain Metastasis Segmentation on Pre- and Post-treatment MRI

Despite continuous advancements in cancer treatment, brain metastatic disease remains a significant complication of primary cancer and is associated with an unfavorable prognosis. One approach for improving diagnosis, management, and outcomes is to implement algorithms based on artificial intelligence for the automated segmentation of both pre- and post-treatment MRI brain images. Such algorithms rely on volumetric criteria for lesion identification and treatment response assessment, which are still not available in clinical practice. Therefore, it is critical to establish tools for rapid volumetric segmentations methods that can be translated to clinical practice and that are trained on high quality annotated data. The BraTS-METS 2025 Lighthouse Challenge aims to address this critical need by establishing inter-rater and intra-rater variability in dataset annotation by generating high quality annotated datasets from four individual instances of segmentation by neuroradiologists while being recorded on video (two instances doing "from scratch" and two instances after AI pre-segmentation). This high-quality annotated dataset will be used for testing phase in 2025 Lighthouse challenge and will be publicly released at the completion of the challenge. The 2025 Lighthouse challenge will also release the 2023 and 2024 segmented datasets that were annotated using an established pipeline of pre-segmentation, student annotation, two neuroradiologists checking, and one neuroradiologist finalizing the process. It builds upon its previous edition by including post-treatment cases in the dataset. Using these high-quality annotated datasets, the 2025 Lighthouse challenge plans to test benchmark algorithms for automated segmentation of pre-and post-treatment brain metastases (BM), trained on diverse and multi-institutional datasets of MRI images obtained from patients with brain metastases.

MetaMorph: Learning Metamorphic Image Transformation With Appearance Changes

This paper presents a novel predictive model, MetaMorph, for metamorphic registration of images with appearance changes (i.e., caused by brain tumors). In contrast to previous learning-based registration methods that have little or no control over appearance-changes, our model introduces a new regularization that can effectively suppress the negative effects of appearance changing areas. In particular, we develop a piecewise regularization on the tangent space of diffeomorphic transformations (also known as initial velocity fields) via learned segmentation maps of abnormal regions. The geometric transformation and appearance changes are treated as joint tasks that are mutually beneficial. Our model MetaMorph is more robust and accurate when searching for an optimal registration solution under the guidance of segmentation, which in turn improves the segmentation performance by providing appropriately augmented training labels. We validate MetaMorph on real 3D human brain tumor magnetic resonance imaging (MRI) scans. Experimental results show that our model outperforms the state-of-the-art learning-based registration models. The proposed MetaMorph has great potential in various image-guided clinical interventions, e.g., real-time image-guided navigation systems for tumor removal surgery.