Real-time brain tumor detection in intraoperative ultrasound: From model training to deployment in the operating room.

Journal: Computers in biology and medicine
Published Date:

Abstract

Intraoperative ultrasound (ioUS) is a valuable tool in brain tumor surgery due to its versatility, affordability, and seamless integration into the surgical workflow. However, its adoption remains limited, primarily because of the challenges associated with image interpretation and the steep learning curve required for effective use. This study aimed to enhance the interpretability of ioUS images by developing a real-time brain tumor detection system deployable in the operating room. We collected 2D ioUS images from the BraTioUS and ReMIND datasets, annotated with expert-refined tumor labels. Using the YOLO11 architecture and its variants, we trained object detection models to identify brain tumors. The dataset included 1732 images from 192 patients, divided into training, validation, and test sets. Data augmentation expanded the training set to 11,570 images. In the test dataset, YOLO11s achieved the best balance of precision and computational efficiency, with a mAP@50 of 0.95, mAP@50-95 of 0.65, and a processing speed of 34.16 frames per second. The proposed solution was prospectively validated in a cohort of 20 consecutively operated patients diagnosed with brain tumors. Neurosurgeons confirmed its seamless integration into the surgical workflow, with real-time predictions accurately delineating tumor regions. These findings highlight the potential of real-time object detection algorithms to enhance ioUS-guided brain tumor surgery, addressing key challenges in interpretation and providing a foundation for future development of computer vision-based tools for neuro-oncological surgery.

Authors

  • Santiago Cepeda
    Neurosurgery Department, Rio Hortega University Hospital, 47012 Valladolid, Spain.
  • Olga Esteban-Sinovas
    Department of Neurosurgery, Rio Hortega University Hospital, Dulzaina 2, Valladolid, 47014, Valladolid, Spain; Specialized Group in Biomedical Imaging and Computational Analysis (GEIBAC), Instituto de Investigacion Biosanitaria de Valladolid (IBioVALL), Dulzaina 2, Valladolid, 47014, Valladolid, Spain.
  • Roberto Romero
    Department of Biology, Center for Genomics & Systems Biology, New York University, New York, NY 10003, Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD and Detroit, MI 48201, USA, IBM Thomas J. Watson Research Center, Yorktown Heights, NY 10598, Computer Science Department, Courant institute of Mathematical Sciences, New York University, New York, NY 10012 and Department of Computer Science, Wayne State University, Detroit, MI 48202, USA.
  • Vikas Singh
    University of Wisconsin-Madison.
  • Prakash Shett
    Department of Neurosurgery, Tata Memorial Centre, Homi Bhabha National Institute, Parel East, Mumbai, 400012, Maharashtra, India.
  • Aliasgar Moiyadi
    Department of Pathology, Tata Memorial Centre, Mumbai 400012, India.
  • Ilyess Zemmoura
    UMR 1253, iBrain, Universit'e de Tours, Inserm, 10 Bd Tonnelle, Tours, 37000, France; Department of Neurosurgery, CHRU de Tours, 2 Bd Tonnelle, Tours, 37000, France.
  • Giuseppe Roberto Giammalva
    Department of Neurosurgery, ARNAS Civico Di Cristina Benfratelli Hospital, P.Za Leotta Nicola, Palermo, 90127, Italy.
  • Massimiliano Del Bene
    Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, via Celoria 11, 20133, Milan, Italy.
  • Arianna Barbotti
    Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, 20133, Italy.
  • Francesco DiMeco
    Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, via Celoria 11, 20133, Milan, Italy.
  • Timothy R West
    Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, 02114, Massachusetts, USA.
  • Brian V Nahed
    Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, 02114, Massachusetts, USA.
  • Ignacio Arrese
    Neurosurgery Department, Rio Hortega University Hospital, 47012 Valladolid, Spain.
  • Roberto Hornero
    Biomedical Engineering Group, University of Valladolid, Valladolid, Spain.
  • Rosario Sarabia
    Neurosurgery Department, Rio Hortega University Hospital, 47012 Valladolid, Spain.