Advancing Brain Tumor Segmentation via Attention-based 3D U-Net Architecture and Digital Image Processing

In the realm of medical diagnostics, rapid advancements in Artificial Intelligence (AI) have significantly yielded remarkable improvements in brain tumor segmentation. Encoder-Decoder architectures, such as U-Net, have played a transformative role by effectively extracting meaningful representations in 3D brain tumor segmentation from Magnetic resonance imaging (MRI) scans. However, standard U-Net models encounter challenges in accurately delineating tumor regions, especially when dealing with irregular shapes and ambiguous boundaries. Additionally, training robust segmentation models on high-resolution MRI data, such as the BraTS datasets, necessitates high computational resources and often faces challenges associated with class imbalance. This study proposes the integration of the attention mechanism into the 3D U-Net model, enabling the model to capture intricate details and prioritize informative regions during the segmentation process. Additionally, a tumor detection algorithm based on digital image processing techniques is utilized to address the issue of imbalanced training data and mitigate bias. This study aims to enhance the performance of brain tumor segmentation, ultimately improving the reliability of diagnosis. The proposed model is thoroughly evaluated and assessed on the BraTS 2020 dataset using various performance metrics to accomplish this goal. The obtained results indicate that the model outperformed related studies, exhibiting dice of 0.975, specificity of 0.988, and sensitivity of 0.995, indicating the efficacy of the proposed model in improving brain tumor segmentation, offering valuable insights for reliable diagnosis in clinical settings.

DRBD-Mamba for Robust and Efficient Brain Tumor Segmentation with Analytical Insights

Accurate brain tumor segmentation is significant for clinical diagnosis and treatment. It is challenging due to the heterogeneity of tumor subregions. Mamba-based State Space Models have demonstrated promising performance. However, they incur significant computational overhead due to sequential feature computation across multiple spatial axes. Moreover, their robustness across diverse BraTS data partitions remains largely unexplored, leaving a critical gap in reliable evaluation. To address these limitations, we propose dual-resolution bi-directional Mamba (DRBD-Mamba), an efficient 3D segmentation model that captures multi-scale long-range dependencies with minimal computational overhead. We leverage a space-filling curve to preserve spatial locality during 3D-to-1D feature mapping, thereby reducing reliance on computationally expensive multi-axial feature scans. To enrich feature representation, we propose a gated fusion module that adaptively integrates forward and reverse contexts, along with a quantization block that discretizes features to improve robustness. In addition, we propose five systematic folds on BraTS2023 for rigorous evaluation of segmentation techniques under diverse conditions and present detailed analysis of common failure scenarios. On the 20\% test set used by recent methods, our model achieves Dice improvements of 0.10\% for whole tumor, 1.75\% for tumor core, and 0.93\% for enhancing tumor. Evaluations on the proposed systematic five folds demonstrate that our model maintains competitive whole tumor accuracy while achieving clear average Dice gains of 0.86\% for tumor core and 1.45\% for enhancing tumor over existing state-of-the-art. Furthermore, our model attains 15 times improvement in efficiency while maintaining high segmentation accuracy, highlighting its robustness and computational advantage over existing approaches.

Demystifying Deep Learning-based Brain Tumor Segmentation with 3D UNets and Explainable AI (XAI): A Comparative Analysis

The current study investigated the use of Explainable Artificial Intelligence (XAI) to improve the accuracy of brain tumor segmentation in MRI images, with the goal of assisting physicians in clinical decision-making. The study focused on applying UNet models for brain tumor segmentation and using the XAI techniques of Gradient-weighted Class Activation Mapping (Grad-CAM) and attention-based visualization to enhance the understanding of these models. Three deep learning models - UNet, Residual UNet (ResUNet), and Attention UNet (AttUNet) - were evaluated to identify the best-performing model. XAI was employed with the aims of clarifying model decisions and increasing physicians' trust in these models. We compared the performance of two UNet variants (ResUNet and AttUNet) with the conventional UNet in segmenting brain tumors from the BraTS2020 public dataset and analyzed model predictions with Grad-CAM and attention-based visualization. Using the latest computer hardware, we trained and validated each model using the Adam optimizer and assessed their performance with respect to: (i) training, validation, and inference times, (ii) segmentation similarity coefficients and loss functions, and (iii) classification performance. Notably, during the final testing phase, ResUNet outperformed the other models with respect to Dice and Jaccard similarity scores, as well as accuracy, recall, and F1 scores. Grad-CAM provided visuospatial insights into the tumor subregions each UNet model focused on while attention-based visualization provided valuable insights into the working mechanisms of AttUNet's attention modules. These results demonstrated ResUNet as the best-performing model and we conclude by recommending its use for automated brain tumor segmentation in future clinical assessments. Our source code and checkpoint are available at https://github.com/ethanong98/MultiModel-XAI-Brats2020

Validation of Various Normalization Methods for Brain Tumor Segmentation: Can Federated Learning Overcome This Heterogeneity?

Deep learning (DL) has been increasingly applied in medical imaging, however, it requires large amounts of data, which raises many challenges related to data privacy, storage, and transfer. Federated learning (FL) is a training paradigm that overcomes these issues, though its effectiveness may be reduced when dealing with non-independent and identically distributed (non-IID) data. This study simulates non-IID conditions by applying different MRI intensity normalization techniques to separate data subsets, reflecting a common cause of heterogeneity. These subsets are then used for training and testing models for brain tumor segmentation. The findings provide insights into the influence of the MRI intensity normalization methods on segmentation models, both training and inference. Notably, the FL methods demonstrated resilience to inconsistently normalized data across clients, achieving the 3D Dice score of 92%, which is comparable to a centralized model (trained using all data). These results indicate that FL is a solution to effectively train high-performing models without violating data privacy, a crucial concern in medical applications. The code is available at: https://github.com/SanoScience/fl-varying-normalization.

VGDM: Vision-Guided Diffusion Model for Brain Tumor Detection and Segmentation

Accurate detection and segmentation of brain tumors from magnetic resonance imaging (MRI) are essential for diagnosis, treatment planning, and clinical monitoring. While convolutional architectures such as U-Net have long been the backbone of medical image segmentation, their limited capacity to capture long-range dependencies constrains performance on complex tumor structures. Recent advances in diffusion models have demonstrated strong potential for generating high-fidelity medical images and refining segmentation boundaries. In this work, we propose VGDM: Vision-Guided Diffusion Model for Brain Tumor Detection and Segmentation framework, a transformer-driven diffusion framework for brain tumor detection and segmentation. By embedding a vision transformer at the core of the diffusion process, the model leverages global contextual reasoning together with iterative denoising to enhance both volumetric accuracy and boundary precision. The transformer backbone enables more effective modeling of spatial relationships across entire MRI volumes, while diffusion refinement mitigates voxel-level errors and recovers fine-grained tumor details. This hybrid design provides a pathway toward improved robustness and scalability in neuro-oncology, moving beyond conventional U-Net baselines. Experimental validation on MRI brain tumor datasets demonstrates consistent gains in Dice similarity and Hausdorff distance, underscoring the potential of transformer-guided diffusion models to advance the state of the art in tumor segmentation.

A Fast and Precise Method for Searching Rectangular Tumor Regions in Brain MR Images

Purpose: To develop a fast and precise method for searching rectangular regions in brain tumor images. Methods: The authors propose a new method for searching rectangular tumor regions in brain MR images. The proposed method consisted of a segmentation network and a fast search method with a user-controllable search metric. As the segmentation network, the U-Net whose encoder was replaced by the EfficientNet was used. In the fast search method, summed-area tables were used for accelerating sums of voxels in rectangular regions. Use of the summed-area tables enabled exhaustive search of the 3D offset (3D full search). The search metric was designed for giving priority to cubes over oblongs, and assigning better values for higher tumor fractions even if they exceeded target tumor fractions. The proposed computation and metric were compared with those used in a conventional method using the Brain Tumor Image Segmentation dataset. Results: When the 3D full search was used, the proposed computation (8 seconds) was 100-500 times faster than the conventional computation (11-40 minutes). When the user-controllable parts of the search metrics were changed variously, the tumor fractions of the proposed metric were higher than those of the conventional metric. In addition, the conventional metric preferred oblongs whereas the proposed metric preferred cubes. Conclusion: The proposed method is promising for implementing fast and precise search of rectangular tumor regions, which is useful for brain tumor diagnosis using MRI systems. The proposed computation reduced processing times of the 3D full search, and the proposed metric improved the quality of the assigned rectangular tumor regions.

A Multicentric Dataset for Training and Benchmarking Breast Cancer Segmentation in H&E Slides

Automated semantic segmentation of whole-slide images (WSIs) stained with hematoxylin and eosin (H&E) is essential for large-scale artificial intelligence-based biomarker analysis in breast cancer. However, existing public datasets for breast cancer segmentation lack the morphological diversity needed to support model generalizability and robust biomarker validation across heterogeneous patient cohorts. We introduce BrEast cancEr hisTopathoLogy sEgmentation (BEETLE), a dataset for multiclass semantic segmentation of H&E-stained breast cancer WSIs. It consists of 587 biopsies and resections from three collaborating clinical centers and two public datasets, digitized using seven scanners, and covers all molecular subtypes and histological grades. Using diverse annotation strategies, we collected annotations across four classes - invasive epithelium, non-invasive epithelium, necrosis, and other - with particular focus on morphologies underrepresented in existing datasets, such as ductal carcinoma in situ and dispersed lobular tumor cells. The dataset's diversity and relevance to the rapidly growing field of automated biomarker quantification in breast cancer ensure its high potential for reuse. Finally, we provide a well-curated, multicentric external evaluation set to enable standardized benchmarking of breast cancer segmentation models.

Uncertainty-Gated Deformable Network for Breast Tumor Segmentation in MR Images

Accurate segmentation of breast tumors in magnetic resonance images (MRI) is essential for breast cancer diagnosis, yet existing methods face challenges in capturing irregular tumor shapes and effectively integrating local and global features. To address these limitations, we propose an uncertainty-gated deformable network to leverage the complementary information from CNN and Transformers. Specifically, we incorporates deformable feature modeling into both convolution and attention modules, enabling adaptive receptive fields for irregular tumor contours. We also design an Uncertainty-Gated Enhancing Module (U-GEM) to selectively exchange complementary features between CNN and Transformer based on pixel-wise uncertainty, enhancing both local and global representations. Additionally, a Boundary-sensitive Deep Supervision Loss is introduced to further improve tumor boundary delineation. Comprehensive experiments on two clinical breast MRI datasets demonstrate that our method achieves superior segmentation performance compared with state-of-the-art methods, highlighting its clinical potential for accurate breast tumor delineation.

No Modality Left Behind: Adapting to Missing Modalities via Knowledge Distillation for Brain Tumor Segmentation

Accurate brain tumor segmentation is essential for preoperative evaluation and personalized treatment. Multi-modal MRI is widely used due to its ability to capture complementary tumor features across different sequences. However, in clinical practice, missing modalities are common, limiting the robustness and generalizability of existing deep learning methods that rely on complete inputs, especially under non-dominant modality combinations. To address this, we propose AdaMM, a multi-modal brain tumor segmentation framework tailored for missing-modality scenarios, centered on knowledge distillation and composed of three synergistic modules. The Graph-guided Adaptive Refinement Module explicitly models semantic associations between generalizable and modality-specific features, enhancing adaptability to modality absence. The Bi-Bottleneck Distillation Module transfers structural and textural knowledge from teacher to student models via global style matching and adversarial feature alignment. The Lesion-Presence-Guided Reliability Module predicts prior probabilities of lesion types through an auxiliary classification task, effectively suppressing false positives under incomplete inputs. Extensive experiments on the BraTS 2018 and 2024 datasets demonstrate that AdaMM consistently outperforms existing methods, exhibiting superior segmentation accuracy and robustness, particularly in single-modality and weak-modality configurations. In addition, we conduct a systematic evaluation of six categories of missing-modality strategies, confirming the superiority of knowledge distillation and offering practical guidance for method selection and future research. Our source code is available at https://github.com/Quanato607/AdaMM.

Transformer Classification of Breast Lesions: The BreastDCEDL_AMBL Benchmark Dataset and 0.92 AUC Baseline

The error is caused by special characters that arXiv's system doesn't recognize. Here's the cleaned version with all problematic characters replaced: Breast magnetic resonance imaging is a critical tool for cancer detection and treatment planning, but its clinical utility is hindered by poor specificity, leading to high false-positive rates and unnecessary biopsies. This study introduces a transformer-based framework for automated classification of breast lesions in dynamic contrast-enhanced MRI, addressing the challenge of distinguishing benign from malignant findings. We implemented a SegFormer architecture that achieved an AUC of 0.92 for lesion-level classification, with 100% sensitivity and 67% specificity at the patient level - potentially eliminating one-third of unnecessary biopsies without missing malignancies. The model quantifies malignant pixel distribution via semantic segmentation, producing interpretable spatial predictions that support clinical decision-making. To establish reproducible benchmarks, we curated BreastDCEDL_AMBL by transforming The Cancer Imaging Archive's AMBL collection into a standardized deep learning dataset with 88 patients and 133 annotated lesions (89 benign, 44 malignant). This resource addresses a key infrastructure gap, as existing public datasets lack benign lesion annotations, limiting benign-malignant classification research. Training incorporated an expanded cohort of over 1,200 patients through integration with BreastDCEDL datasets, validating transfer learning approaches despite primary tumor-only annotations. Public release of the dataset, models, and evaluation protocols provides the first standardized benchmark for DCE-MRI lesion classification, enabling methodological advancement toward clinical deployment.