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RESUMEN: La clasificación de los Tumores Primarios del Sistema Nervioso Central (SNC) tiene su origen en la descripción morfológica, cuyo análisis histopatológico ha permitido identificar la línea celular involucrada en estos tumores y obtener el reconocimiento de ciertas características de estas lesiones y su evolución clínica. El estudio molecular ha venido a complementar el diagnóstico inicial permitiendo reconocer entidades que no son distinguibles de otra manera y que han variado los conceptos y definiciones de varias entidades patológicas que modifican el horizonte visible de estas enfermedades. El papel de las imágenes de Resonancia Magnética (RM) en el manejo de los tumores intraaxiales se puede dividir ampliamente en el diagnóstico y la clasificación de los tumores, la planificación del tratamiento y el tratamiento posterior. El presente artículo resume la evidencia epidemiológica relacionada en la clasificación de los tumores primarios del SNC con marcadores moleculares y biomarcadores de imágenes de RM, apuntando a la importancia del uso de la investigación clínica con el manejo terapéutico.

SUMMARY: The classification of primary tumors of the Central Nervous System (CNS) has its origin in the morphological description whose histopathological analysis has allowed to identify the cell line involved in these tumors and obtain the recognition of certain characteristics of these lesions and their clinical evolution. The molecular study has come to complement the initial diagnosis allowing to recognize entities that are not distinguishable in another way and that have varied the concepts and definitions of various pathological entities modifying the visible horizon of these diseases. The role of Magnetic Resonance (MR) images in the management of intraaxial tumors can be broadly divided into the diagnosis and classification of tumors, treatment planning and subsequent treatment. The present article summarizes the epidemiologic evidence related to the classification of primary tumors of the CNS with molecular markers and MR imaging biomarkers.

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Several brain disorders are associated with abnormal brain asymmetries (asymmetric anomalies). Several computer-based methods aim to detect such anomalies automatically. Recent advances in this area use automatic unsupervised techniques that extract pairs of symmetric supervoxels in the hemispheres, model normal brain asymmetries for each pair from healthy subjects, and treat outliers as anomalies. Yet, there is no deep understanding of the impact of the supervoxel segmentation quality for abnormal asymmetry detection, especially for small anomalies, nor of the added value of using a specialized model for each supervoxel pair instead of a single global appearance model. We aim to answer these questions by a detailed evaluation of different scenarios for supervoxel segmentation and classification for detecting abnormal brain asymmetries. Experimental results on 3D MR-T1 brain images of stroke patients confirm the importance of high-quality supervoxels fit anomalies and the use of a specific classifier for each supervoxel. Next, we present a refinement of the detection method that reduces the number of false-positive supervoxels, thereby making the detection method easier to use for visual inspection and analysis of the found anomalies.

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Magnetic Resonance (MR) Imaging is a diagnostic technique that produces noisy images, which must be filtered before processing to prevent diagnostic errors. However, filtering the noise while keeping fine details is a difficult task. This paper presents a method, based on sparse representations and singular value decomposition (SVD), for non-locally denoising MR images. The proposed method prevents blurring, artifacts, and residual noise. Our method is composed of three stages. The first stage divides the image into sub-volumes, to obtain its sparse representation, by using the KSVD algorithm. Then, the global influence of the dictionary atoms is computed to upgrade the dictionary and obtain a better reconstruction of the sub-volumes. In the second stage, based on the sparse representation, the noise-free sub-volume is estimated using a non-local approach and SVD. The noise-free voxel is reconstructed by aggregating the overlapped voxels according to the rarity of the sub-volumes it belongs, which is computed from the global influence of the atoms. The third stage repeats the process using a different sub-volume size for producing a new filtered image, which is averaged with the previously filtered images. The results provided show that our method outperforms several state-of-the-art methods in both simulated and real data.

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PURPOSE: Automated segmentation of brain structures (objects) in MR three-dimensional (3D) images for quantitative analysis has been a challenge and probabilistic atlases (PAs) are among the most well-succeeded approaches. However, the existing models do not adapt to possible object anomalies due to the presence of a disease or a surgical procedure. Post-processing operation does not solve the problem, for example, tissue classification to detect and remove such anomalies inside the resulting segmentation mask, because segmentation errors on healthy tissues cannot be fixed. Such anomalies very often alter the shape and texture of the brain structures, making them different from the appearance of the model. In this paper, we present an effective and efficient adaptive probabilistic atlas, named AdaPro, to circumvent the problem and evaluate it on a challenging task - the segmentation of the left hemisphere, right hemisphere, and cerebellum, without pons and medulla, in 3D MR-T1 brain images of Epilepsy patients. This task is challenging due to temporal lobe resections, artifacts, and the absence of contrast in some parts between the structures of interest. METHODS: In AdaPro, we first build one probabilistic atlas per object of interest from a training set with normal 3D images and the corresponding 3D object masks. Second, we incorporate a texture classifier based on convex optimization which dynamically indicates the regions of the target 3D image where the PAs (shape constraints) should be further adapted. This strategy is mathematically more elegant and avoids problems with post-processing. Third, we add a new object-based delineation algorithm based on combinatorial optimization and diffusion filtering. AdaPro can then be used to locate and delineate the objects in the coordinate space of the atlas or of the test image. We also compare AdaPro with three other state-of-the-art methods: an statistical shape model based on synergistic object search and delineation, and two methods based on multi-atlas label fusion (MALF). RESULTS: We evaluate the methods quantitatively on 3D MR-T1 brain images of 2T and 3T from epilepsy patients, before and after temporal lobe resections, and on the template and native coordinate spaces. The results show that AdaPro is considerably faster and consistently more accurate than the baselines with statistical significance in both coordinate spaces. CONCLUSION: AdaPro can be used as a fast and effective step for brain tissue segmentation and it can also be easily extended to segment subcortical brain structures. By choice of its components, probabilistic atlas, texture classifier, and delineation algorithm, it can also be extended to other organs and imaging modalities.

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PURPOSE: Accurate prostate delineation is necessary in radiotherapy processes for concentrating the dose onto the prostate and reducing side effects in neighboring organs. Currently, manual delineation is performed over magnetic resonance imaging (MRI) taking advantage of its high soft tissue contrast property. Nevertheless, as human intervention is a consuming task with high intra- and interobserver variability rates, (semi)-automatic organ delineation tools have emerged to cope with these challenges, reducing the time spent for these tasks. This work presents a multiresolution representation that defines a novel metric and allows to segment a new prostate by combining a set of most similar prostates in a dataset. METHODS: The proposed method starts by selecting the set of most similar prostates with respect to a new one using the proposed multiresolution representation. This representation characterizes the prostate through a set of salient points, extracted from a region of interest (ROI) that encloses the organ and refined using structural information, allowing to capture main relevant features of the organ boundary. Afterward, the new prostate is automatically segmented by combining the nonrigidly registered expert delineations associated to the previous selected similar prostates using a weighted patch-based strategy. Finally, the prostate contour is smoothed based on morphological operations. RESULTS: The proposed approach was evaluated with respect to the expert manual segmentation under a leave-one-out scheme using two public datasets, obtaining averaged Dice coefficients of 82% ± 0.07 and 83% ± 0.06, and demonstrating a competitive performance with respect to atlas-based state-of-the-art methods. CONCLUSIONS: The proposed multiresolution representation provides a feature space that follows a local salient point criteria and a global rule of the spatial configuration among these points to find out the most similar prostates. This strategy suggests an easy adaptation in the clinical routine, as supporting tool for annotation.

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