The MAMA-MIA Challenge: Advancing Generalizability and Fairness in Breast MRI Tumor Segmentation and Treatment Response Prediction

Breast cancer is the most frequently diagnosed malignancy among women worldwide and a leading cause of cancer-related mortality. Dynamic contrast-enhanced magnetic resonance imaging plays a central role in tumor characterization and treatment monitoring, particularly in patients receiving neoadjuvant chemotherapy. However, existing artificial intelligence models for breast magnetic resonance imaging are often developed using single-center data and evaluated using aggregate performance metrics, limiting their generalizability and obscuring potential performance disparities across demographic subgroups. The MAMA-MIA Challenge was designed to address these limitations by introducing a large-scale benchmark that jointly evaluates primary tumor segmentation and prediction of pathologic complete response using pre-treatment magnetic resonance imaging only. The training cohort comprised 1,506 patients from multiple institutions in the United States, while evaluation was conducted on an external test set of 574 patients from three independent European centers to assess cross-continental and cross-institutional generalization. A unified scoring framework combined predictive performance with subgroup consistency across age, menopausal status, and breast density. Twenty-six international teams participated in the final evaluation phase. Results demonstrate substantial performance variability under external testing and reveal trade-offs between overall accuracy and subgroup fairness. The challenge provides standardized datasets, evaluation protocols, and public resources to promote the development of robust and equitable artificial intelligence systems for breast cancer imaging.

Tumor Detection, Segmentation and Classification Challenge on Automated 3D Breast Ultrasound: The TDSC-ABUS Challenge

Breast cancer is one of the most common causes of death among women worldwide. Early detection helps in reducing the number of deaths. Automated 3D Breast Ultrasound (ABUS) is a newer approach for breast screening, which has many advantages over handheld mammography such as safety, speed, and higher detection rate of breast cancer. Tumor detection, segmentation, and classification are key components in the analysis of medical images, especially challenging in the context of 3D ABUS due to the significant variability in tumor size and shape, unclear tumor boundaries, and a low signal-to-noise ratio. The lack of publicly accessible, well-labeled ABUS datasets further hinders the advancement of systems for breast tumor analysis. Addressing this gap, we have organized the inaugural Tumor Detection, Segmentation, and Classification Challenge on Automated 3D Breast Ultrasound 2023 (TDSC-ABUS2023). This initiative aims to spearhead research in this field and create a definitive benchmark for tasks associated with 3D ABUS image analysis. In this paper, we summarize the top-performing algorithms from the challenge and provide critical analysis for ABUS image examination. We offer the TDSC-ABUS challenge as an open-access platform at https://tdsc-abus2023.grand-challenge.org/ to benchmark and inspire future developments in algorithmic research.

Demystifying the Effect of Receptive Field Size in U-Net Models for Medical Image Segmentation

Medical image segmentation is a critical task in healthcare applications, and U-Nets have demonstrated promising results. This work delves into the understudied aspect of receptive field (RF) size and its impact on the U-Net and Attention U-Net architectures. This work explores several critical elements including the relationship between RF size, characteristics of the region of interest, and model performance, as well as the balance between RF size and computational costs for U-Net and Attention U-Net methods for different datasets. This work also proposes a mathematical notation for representing the theoretical receptive field (TRF) of a given layer in a network and proposes two new metrics - effective receptive field (ERF) rate and the Object rate to quantify the fraction of significantly contributing pixels within the ERF against the TRF area and assessing the relative size of the segmentation object compared to the TRF size respectively. The results demonstrate that there exists an optimal TRF size that successfully strikes a balance between capturing a wider global context and maintaining computational efficiency, thereby optimizing model performance. Interestingly, a distinct correlation is observed between the data complexity and the required TRF size; segmentation based solely on contrast achieved peak performance even with smaller TRF sizes, whereas more complex segmentation tasks necessitated larger TRFs. Attention U-Net models consistently outperformed their U-Net counterparts, highlighting the value of attention mechanisms regardless of TRF size. These novel insights present an invaluable resource for developing more efficient U-Net-based architectures for medical imaging and pave the way for future exploration. A tool is also developed that calculates the TRF for a U-Net (and Attention U-Net) model, and also suggest an appropriate TRF size for a given model and dataset.

Multi-Threshold Attention U-Net based Model for Multimodal Brain Tumor Segmentation in MRI scans

Gliomas are one of the most frequent brain tumors and are classified into high grade and low grade gliomas. The segmentation of various regions such as tumor core, enhancing tumor etc. plays an important role in determining severity and prognosis. Here, we have developed a multi-threshold model based on attention U-Net for identification of various regions of the tumor in magnetic resonance imaging (MRI). We propose a multi-path segmentation and built three separate models for the different regions of interest. The proposed model achieved mean Dice Coefficient of 0.59, 0.72, and 0.61 for enhancing tumor, whole tumor and tumor core respectively on the training dataset. The same model gave mean Dice Coefficient of 0.57, 0.73, and 0.61 on the validation dataset and 0.59, 0.72, and 0.57 on the test dataset.