title: Multi-parametric (ADC/PWI/T2-w) image fusion approach for accurate semi-automatic segmentation of tumorous regions in glioblastoma multiforme.
abstract: OBJECTIVE
  Glioblastoma multiforme (GBM) brain tumor is heterogeneous in nature, so its quantification depends on how to accurately segment different parts of the tumor, i.e. viable tumor, edema and necrosis. This procedure becomes more effective when metabolic and functional information, provided by physiological magnetic resonance (MR) imaging modalities, like diffusion-weighted-imaging (DWI) and perfusion-weighted-imaging (PWI), is incorporated with the anatomical magnetic resonance imaging (MRI). In this preliminary tumor quantification work, the idea is to characterize different regions of GBM tumors in an MRI-based semi-automatic multi-parametric approach to achieve more accurate characterization of pathogenic regions.
  
  
  METHODS
  For this purpose, three MR sequences, namely T2-weighted imaging (anatomical MR imaging), PWI and DWI of thirteen GBM patients, were acquired. To enhance the delineation of the boundaries of each pathogenic region (peri-tumoral edema, viable tumor and necrosis), the spatial fuzzy C-means algorithm is combined with the region growing method.
  
  
  RESULTS
  The results show that exploiting the multi-parametric approach along with the proposed semi-automatic segmentation method can differentiate various tumorous regions with over 80 % sensitivity, specificity and dice score.
  
  
  CONCLUSIONS
  The proposed MRI-based multi-parametric segmentation approach has the potential to accurately segment tumorous regions, leading to an efficient design of the pre-surgical treatment planning.
authors.affiliation: Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Anahita
authors.initials: A
authors.lastname: Fathi Kazerooni
authors.forename: Meysam
authors.initials: M
authors.lastname: Mohseni
authors.forename: Sahar
authors.initials: S
authors.lastname: Rezaei
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Bakhshandehpour
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Saligheh Rad
mesh_terms: D000465:Algorithms; D001932:Brain Neoplasms / Q000473:pathology*; D005909:Glioblastoma / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D000069550:Machine Learning; D008279:Magnetic Resonance Imaging / Q000379:methods*; D064847:Multimodal Imaging / Q000379:methods*; D010363:Pattern Recognition, Automated / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique