Accuracy of TrUE-Net in comparison to established white matter hyperintensity segmentation methods: An independent validation study

Jeremy F Strain, Washington University School of Medicine in St. Louis
Maryam Rahmani, Washington University School of Medicine in St. Louis
Donna Dierker, Washington University School of Medicine in St. Louis
Christopher Owen, Washington University School of Medicine in St. Louis
Hussain Jafri, Washington University School of Medicine in St. Louis
Andrei G Vlassenko, Washington University School of Medicine in St. Louis
Kyle Womack, Washington University School of Medicine in St. Louis
Jurgen Fripp, CSIRO Health and Biosecurity
Duygu Tosun, University of California, San Francisco
Tammie L S Benzinger, Washington University School of Medicine in St. Louis
Michael Weiner, University of California, San Francisco
Colin Masters, University of Melbourne
Jin-Moo Lee, Washington University School of Medicine in St. Louis
John C Morris, Washington University School of Medicine in St. Louis
Manu S Goyal, Washington University School of Medicine in St. Louis
ADOPIC and ADNI Investigators

Abstract

White matter hyperintensities (WMH) are nearly ubiquitous in the aging brain, and their topography and overall burden are associated with cognitive decline. Given their numerosity, accurate methods to automatically segment WMH are needed. Recent developments, including the availability of challenge data sets and improved deep learning algorithms, have led to a new promising deep-learning based automated segmentation model called TrUE-Net, which has yet to undergo rigorous independent validation. Here, we compare TrUE-Net to six established automated WMH segmentation tools, including a semi-manual method. We evaluated the techniques at both global and regional level to compare their ability to detect the established relationship between WMH burden and age. We found that TrUE-Net was highly reliable at identifying WMH regions with low false positive rates, when compared to semi-manual segmentation as the reference standard. TrUE-Net performed similarly or favorably when compared to the other automated techniques. Moreover, TrUE-Net was able to detect relationships between WMH and age to a similar degree as the reference standard semi-manual segmentation at both the global and regional level. These results support the use of TrUE-Net for identifying WMH at the global or regional level, including in large, combined datasets.