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The burgeoning field of brain health research increasingly leverages artificial intelligence (AI) to analyze and interpret neuroimaging data. Medical foundation models have shown promise of superior performance with better sample efficiency. This work introduces a novel approach towards creating 3-dimensional (3D) medical foundation models for multimodal neuroimage segmentation through self-supervised training. Our approach involves a novel two-stage pretraining approach using vision transformers. The first stage encodes anatomical structures in generally healthy brains from the large-scale unlabeled neuroimage dataset of multimodal brain magnetic resonance imaging (MRI) images from 41,400 participants. This stage of pertaining focuses on identifying key features such as shapes and sizes of different brain structures. The second pretraining stage identifies disease-specific attributes, such as geometric shapes of tumors and lesions and spatial placements within the brain. This dual-phase methodology significantly reduces the extensive data requirements usually necessary for AI model training in neuroimage segmentation with the flexibility to adapt to various imaging modalities. We rigorously evaluate our model, BrainSegFounder, using the Brain Tumor Segmentation (BraTS) challenge and Anatomical Tracings of Lesions After Stroke v2.0 (ATLAS v2.0) datasets. BrainSegFounder demonstrates a significant performance gain, surpassing the achievements of the previous winning solutions using fully supervised learning. Our findings underscore the impact of scaling up both the model complexity and the volume of unlabeled training data derived from generally healthy brains. Both of these factors enhance the accuracy and predictive capabilities of the model in neuroimage segmentation tasks. Our pretrained models and code are at https://github.com/lab-smile/BrainSegFounder. 

Abstract Whole-head segmentation from Magnetic Resonance Images (MRI) establishes the foundation for individualized computational models using finite element method (FEM). This foundation paves the path for computer-aided solutions in fields such as non-invasive brain stimulation. Most current automatic head segmentation tools are developed using healthy young adults. Thus, they may neglect the older population that is more prone to age-related structural decline such as brain atrophy. In this work, we present a new deep learning method called GRACE, which stands for General, Rapid, And Comprehensive whole-hEad tissue segmentation. GRACE is trained and validated on a novel dataset that consists of 177 manually corrected MR-derived reference segmentations that have undergone meticulous manual review. Each T1-weighted MRI volume is segmented into 11 tissue types, including white matter, grey matter, eyes, cerebrospinal fluid, air, blood vessel, cancellous bone, cortical bone, skin, fat, and muscle. To the best of our knowledge, this work contains the largest manually corrected dataset to date in terms of number of MRIs and segmented tissues. GRACE outperforms five freely available software tools and a traditional 3D U-Net on a five-tissue segmentation task. On this task, GRACE achieves an average Hausdorff Distance of 0.21, which exceeds the runner-up at an average Hausdorff Distance of 0.36. GRACE can segment a whole-head MRI in about 3 seconds, while the fastest software tool takes about 3 minutes. In summary, GRACE segments a spectrum of tissue types from older adults’ T1-MRI scans at favorable accuracy and speed. The trained GRACE model is optimized on older adult heads to enable high-precision modeling in age-related brain disorders. To support open science, the GRACE code and trained weights are made available online and open to the research community at https://github.com/lab-smile/GRACE.