Robust brain extraction across datasets and comparison with publicly available methods.

Automatic whole-brain extraction from magnetic resonance images (MRI), also known as skull stripping, is a key component in most neuroimage pipelines. As the first element in the chain, its robustness is critical for the overall performance of the system. Many skull stripping methods have been proposed, but the problem is not considered to be completely solved yet. Many systems in the literature have good performance on certain datasets (mostly the datasets they were trained/tuned on), but fail to produce satisfactory results when the acquisition conditions or study populations are different. In this paper we introduce a robust, learning-based brain extraction system (ROBEX). The method combines a discriminative and a generative model to achieve the final result. The discriminative model is a Random Forest classifier trained to detect the brain boundary; the generative model is a point distribution model that ensures that the result is plausible. When a new image is presented to the system, the generative model is explored to find the contour with highest likelihood according to the discriminative model. Because the target shape is in general not perfectly represented by the generative model, the contour is refined using graph cuts to obtain the final segmentation. Both models were trained using 92 scans from a proprietary dataset but they achieve a high degree of robustness on a variety of other datasets. ROBEX was compared with six other popular, publicly available methods (BET, BSE, FreeSurfer, AFNI, BridgeBurner, and GCUT) on three publicly available datasets (IBSR, LPBA40, and OASIS, 137 scans in total) that include a wide range of acquisition hardware and a highly variable population (different age groups, healthy/diseased). The results show that ROBEX provides significantly improved performance measures for almost every method/dataset combination.