Article Text

Original research
Automatic brain lesion segmentation on standard magnetic resonance images: a scoping review
  1. Emilia Gryska1,
  2. Justin Schneiderman2,
  3. Isabella Björkman-Burtscher3,
  4. Rolf A Heckemann1
  1. 1Medical Radiation Sciences, Goteborgs universitet Institutionen for kliniska vetenskaper, Goteborg, Sweden
  2. 2Sektionen för klinisk neurovetenskap, Goteborgs Universitet Institutionen for Neurovetenskap och fysiologi, Goteborg, Sweden
  3. 3Radiology, Göteborgs universitet Institutionen för kliniska vetenskaper, Goteborg, Västra Götaland, Sweden
  1. Correspondence to Emilia Gryska; emilia.gryska{at}


Objectives Medical image analysis practices face challenges that can potentially be addressed with algorithm-based segmentation tools. In this study, we map the field of automatic MR brain lesion segmentation to understand the clinical applicability of prevalent methods and study designs, as well as challenges and limitations in the field.

Design Scoping review.

Setting Three databases (PubMed, IEEE Xplore and Scopus) were searched with tailored queries. Studies were included based on predefined criteria. Emerging themes during consecutive title, abstract, methods and whole-text screening were identified. The full-text analysis focused on materials, preprocessing, performance evaluation and comparison.

Results Out of 2990 unique articles identified through the search, 441 articles met the eligibility criteria, with an estimated growth rate of 10% per year. We present a general overview and trends in the field with regard to publication sources, segmentation principles used and types of lesions. Algorithms are predominantly evaluated by measuring the agreement of segmentation results with a trusted reference. Few articles describe measures of clinical validity.

Conclusions The observed reporting practices leave room for improvement with a view to studying replication, method comparison and clinical applicability. To promote this improvement, we propose a list of recommendations for future studies in the field.

  • radiology & imaging
  • magnetic resonance imaging
  • diagnostic radiology
  • neuroradiology

Data availability statement

Data are available in a public, open access repository. DOI: 10.6084/m9.figshare.13651235

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

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Data availability statement

Data are available in a public, open access repository. DOI: 10.6084/m9.figshare.13651235

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  • Contributors EG conducted the study and led the writing of the article. RAH was the main supervisor and consultant of the study progress and design choices. JS provided input on the study plan and methodology at all stages. IB-B provided guidance on the interpretation of the findings from a clinical perspective. All coauthors collaborated on manuscript composition and editing.

  • Funding JFS is supported by the Swedish Childhood Cancer Foundation (MT2018-0020) and the ATTRACT project funded by the EC under Grant agreement 777222.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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