@article {308,
	title = {Automatic Brain Segmentation in Time-of-Flight MRA Images},
	journal = {Methods of information in medicine},
	volume = {48},
	year = {2009},
	month = {2009},
	pages = {399-407},
	abstract = {OBJECTIVES: Cerebral vascular malformations might, caused by ruptures, lead to strokes. The rupture risk depends to a great extent on the individual anatomy of the vasculature. The 3D Time-of-Flight (TOF) MRA technique is one of the most commonly used non-invasive imaging techniques to obtain knowledge about the individual vascular anatomy. Unfortunately TOF images exhibit drawbacks for segmentation and direct volume visualization of the vasculature. To overcome these drawbacks an initial segmentation of the brain tissue is required.

METHODS: After preprocessing of the data is applied the low-intensity tissues surrounding the brain are segmented using region growing. In a following step this segmentation is used to extract supporting points at the border of the brain for a graph-based contour extraction. Finally a consistency check is performed to identify local outliers which are corrected using non-linear registration.

RESULTS: A quantitative validation of the method proposed was performed on 18 clinical datasets based on manual segmentations. A mean Dice coefficient of 0.989 was achieved while in average 99.56\% of all vessel voxels were included by the brain segmentation. A comparison to the results yielded by three commonly used tools for brain segmentation revealed that the method described achieves better results, using TOF images as input, which are within the inter-observer variability.

CONCLUSION: The method suggested allows a robust and automatic segmentation of brain tissue in TOF images. It is especially helpful to improve the automatic segmentation or direct volume rendering of the cerebral vascular system.},
	keywords = {Algorithms, Artifacts, Cerebral Arteries, Cerebral Veins, Humans, Image Enhancement, Image Interpretation, Computer-Assisted, Image Processing, Computer-Assisted, Imaging, Three-Dimensional, Intracranial Arteriovenous Malformations, Magnetic Resonance Angiography, Sensitivity and Specificity, Software},
	issn = {0026-1270},
	doi = {10.3414/ME9237},
	author = {Forkert, Nils Daniel and S{\"a}ring, Dennis and Fiehler, Jens and Illies, T. and M{\"o}ller, D. and Heinz Handels}
}
