Glioblastoma Segmentation: Comparison of Three Different Software Packages

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.

为推动三维体积肿瘤分割在临床研究中的更广泛应用，亟需开发可靠且易用的分割软件。因此本研究旨在对比三款用于胶质母细胞瘤半自动脑肿瘤分割的软件工具——BrainVoyager™ QX、ITK-Snap及3D Slicer，并公开相关数据以供后续参考。
本研究纳入20例因胶质母细胞瘤接受手术的连续患者，获取其术前对比增强T1加权1.5T或3T磁共振成像（MRI）扫描影像。由两名研究者分别使用三款软件对所有MRI扫描影像各完成两次肿瘤分割操作。采用均值差结合95%一致性界限（LoA）、戴斯相似系数（DSC）及豪斯多夫距离（HD），对组内、组间及软件间的分割一致性进行对比分析，并通过秒表记录每一次分割操作的总耗时。
最终有18例肿瘤病灶纳入本次分析。组间一致性以BrainVoyager™ QX表现最优，其均值差为0.19 mL，95%一致性界限范围为-2.42 mL至2.81 mL。三款软件的软件间一致性及95%一致性界限范围均较为相近。所有分析中的组内、组间及软件间DSC值均≥0.93。BrainVoyager™ QX单次分割耗时约41分钟，而3D Slicer与ITK-Snap的单次分割耗时均约为18分钟。
本研究核心结果显示：三款软件的组内、组间及软件间分割一致性均较高，表现为均值差较小且DSC值优异；其中BrainVoyager™ QX耗时最长，但三款软件整体耗时均偏高，或限制其在日常临床场景中的应用可行性。