title: Glioblastoma Segmentation: Comparison of Three Different Software Packages.
abstract: To facilitate a more widespread use of volumetric tumor segmentation in clinical studies, there is an urgent need for reliable, user-friendly segmentation software. The aim of this study was therefore to compare three different software packages for semi-automatic brain tumor segmentation of glioblastoma; namely BrainVoyagerTM QX, ITK-Snap and 3D Slicer, and to make data available for future reference. Pre-operative, contrast enhanced T1-weighted 1.5 or 3 Tesla Magnetic Resonance Imaging (MRI) scans were obtained in 20 consecutive patients who underwent surgery for glioblastoma. MRI scans were segmented twice in each software package by two investigators. Intra-rater, inter-rater and between-software agreement was compared by using differences of means with 95% limits of agreement (LoA), Dice's similarity coefficients (DSC) and Hausdorff distance (HD). Time expenditure of segmentations was measured using a stopwatch. Eighteen tumors were included in the analyses. Inter-rater agreement was highest for BrainVoyager with difference of means of 0.19 mL and 95% LoA from -2.42 mL to 2.81 mL. Between-software agreement and 95% LoA were very similar for the different software packages. Intra-rater, inter-rater and between-software DSC were ≥ 0.93 in all analyses. Time expenditure was approximately 41 min per segmentation in BrainVoyager, and 18 min per segmentation in both 3D Slicer and ITK-Snap. Our main findings were that there is a high agreement within and between the software packages in terms of small intra-rater, inter-rater and between-software differences of means and high Dice's similarity coefficients. Time expenditure was highest for BrainVoyager, but all software packages were relatively time-consuming, which may limit usability in an everyday clinical setting.
authors: Department of Neurosurgery, St. Olav's University Hospital, Trondheim, Norway.
authors: Even Hovig
authors: EH
authors: Fyllingen
authors: Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors: Anne Line
authors: http://orcid.org/0000-0001-8482-8101
authors: AL
authors: Stensjøen
authors: Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Radiology and Nuclear Medicine, St. Olav's University Hospital, Trondheim, Norway.
authors: Erik Magnus
authors: EM
authors: Berntsen
authors: Department of Neurosurgery, St. Olav's University Hospital, Trondheim, Norway.|Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors: Ole
authors: O
authors: Solheim
authors: Department of Neurosurgery, St. Olav's University Hospital, Trondheim, Norway.|SINTEF, Technology and Society, Dept. Medical technology, Trondheim, Norway.
authors: Ingerid
authors: I
authors: Reinertsen
mesh_terms: D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional; D015203:Reproducibility of Results; D012984:Software; D014584:User-Computer Interface