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Postoperative glioma segmentation in CT image using deep feature fusion model guided by multi-sequence MRIs



Computed tomography (CT) and magnetic resonance imaging (MRI) are the most commonly selected methods for imaging gliomas. Clinically, radiotherapists always delineate the CT glioma region with reference to multi-modal MR image information. On this basis, we develop a deep feature fusion model (DFFM) guided by multi-sequence MRIs for postoperative glioma segmentation in CT images.


DFFM is a multi-sequence MRI–guided convolutional neural network (CNN) that iteratively learns the deep features from CT images and multi-sequence MR images simultaneously by utilizing a multi-channel CNN architecture, and then combines these two deep features together to produce the segmentation result. The whole network is optimized together via a standard back-propagation. A total of 59 CT and MRI datasets (T1/T2-weighted FLAIR, T1-weighted contrast-enhanced, T2-weighted) of postoperative gliomas as tumor grade II (n = 24), grade III (n = 18), or grade IV (n = 17) were included. Dice coefficient (DSC), precision, and recall were used to measure the overlap between automated segmentation results and manual segmentation. The Wilcoxon signed-rank test was used for statistical analysis.


DFFM showed a significantly (p < 0.01) higher DSC of 0.836 than U-Net trained by single CT images and U-Net trained by stacking the CT and multi-sequence MR images, which yielded 0.713 DSC and 0.818 DSC, respectively. The precision values showed similar behavior as DSC. Moreover, DSC and precision values have no significant statistical difference (p > 0.01) with difference grades.


DFFM enables the accurate automated segmentation of CT postoperative gliomas of profit guided by multi-sequence MR images and may thus improve and facilitate radiotherapy planning.

Key Points

• A fully automated deep learning method was developed to segment postoperative gliomas on CT images guided by multi-sequence MRIs.

• CT and multi-sequence MR image integration allows for improvements in deep learning postoperative glioma segmentation method.

• This deep feature fusion model produces reliable segmentation results and could be useful in delineating GTV in postoperative glioma radiotherapy planning.

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  1. Code source:



Convolutional neural networks


Deep feature fusion model


Fluid-attenuated inversion recovery


Gross tumor volume


T1-weighted contrast-enhanced


U-Net trained by single CT images


U-Net trained by stacking the CT and multi-sequence MR images


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The authors would like to thank the reviewers for their fruitful comments.


This study has received funding by the National Natural Science Foundation of China under Grant Nos. 61671230 and 31271067, the Science and Technology Program of Guangdong Province under Grant No. 2017A020211012, the Guangdong Provincial Key Laboratory of Medical Image Processing under Grant No. 2014B030301042, and the Science and Technology Program of Guangzhou under Grant No. 201607010097.

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Correspondence to Yu Zhang or Linghong Zhou.

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Tang, F., Liang, S., Zhong, T. et al. Postoperative glioma segmentation in CT image using deep feature fusion model guided by multi-sequence MRIs. Eur Radiol 30, 823–832 (2020).

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  • Glioma
  • Machine learning
  • Magnetic resonance imaging
  • Radiotherapy