Standardized Evaluation of Automatic Methods for Perivascular Spaces Segmentation in MRI -- MICCAI 2024 Challenge Results

Yilei Wu; Yichi Zhang; Zijian Dong; Fang Ji; An Sen Tan; Gifford Tan; Sizhao Tang; Huijuan Chen; Zijiao Chen; Eric Kwun Kei Ng; Jose Bernal; Hang Min; Ying Xia; Ines Vati; Liz Cooper; Xiaoyu Hu; Yuchen Pei; Yutao Ma; Victor Nozais; Ami Tsuchida; Pierre-Yves Hervé; Philippe Boutinaud; Marc Joliot; Junghwa Kang; Wooseung Kim; Dayeon Bak; Rachika E. Hamadache; Valeriia Abramova; Xavier Lladó; Yuntao Zhu; Zhenyu Gong; Xin Chen; John McFadden; Pek Lan Khong; Roberto Duarte Coello; Hongwei Bran Li; Woon Puay Koh; Christopher Chen; Joanna M. Wardlaw; Maria del C. Valdés Hernández; Juan Helen Zhou

arXiv · 2512.18197

Standardized Evaluation of Automatic Methods for Perivascular Spaces Segmentation in MRI -- MICCAI 2024 Challenge Results

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Abstract

Perivascular spaces (PVS), when abnormally enlarged and visible in magnetic resonance imaging (MRI) structural sequences, are important imaging markers of cerebral small vessel disease and potential indicators of neurodegenerative conditions. Despite their clinical significance, automatic enlarged PVS (EPVS) segmentation remains challenging due to their small size, variable morphology, similarity with other pathological features, and limited annotated datasets. This paper presents the EPVS Challenge organized at MICCAI 2024, which aims to advance the development of automated algorithms for EPVS segmentation across multi-site data. We provided a diverse dataset comprising 100 training, 50 validation, and 50 testing scans collected from multiple international sites (UK, Singapore, and China) with varying MRI protocols and demographics. All annotations followed the STRIVE protocol to ensure standardized ground truth and covered the full brain parenchyma. Seven teams completed the full challenge, implementing various deep learning approaches primarily based on U-Net architectures with innovations in multi-modal processing, ensemble strategies, and transformer-based components. Performance was evaluated using dice similarity coefficient, absolute volume difference, recall, and precision metrics. The winning method employed MedNeXt architecture with a dual 2D/3D strategy for handling varying slice thicknesses. The top solutions showed relatively good performance on test data from seen datasets, but significant degradation of performance was observed on the previously unseen Shanghai cohort, highlighting cross-site generalization challenges due to domain shift. This challenge establishes an important benchmark for EPVS segmentation methods and underscores the need for the continued development of robust algorithms that can generalize in diverse clinical settings.

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Yilei Wu, Yichi Zhang, Zijian Dong, Fang Ji, An Sen Tan, Gifford Tan, Sizhao Tang, Huijuan Chen, Zijiao Chen, Eric Kwun Kei Ng, Jose Bernal, Hang Min, Ying Xia, Ines Vati, Liz Cooper, Xiaoyu Hu, Yuchen Pei, Yutao Ma, Victor Nozais, Ami Tsuchida, Pierre-Yves Hervé, Philippe Boutinaud, Marc Joliot, Junghwa Kang, Wooseung Kim, Dayeon Bak, Rachika E. Hamadache, Valeriia Abramova, Xavier Lladó, Yuntao Zhu, Zhenyu Gong, Xin Chen, John McFadden, Pek Lan Khong, Roberto Duarte Coello, Hongwei Bran Li, Woon Puay Koh, Christopher Chen, Joanna M. Wardlaw, Maria del C. Valdés Hernández, Juan Helen Zhou. 2025-12-20. Standardized Evaluation of Automatic Methods for Perivascular Spaces Segmentation in MRI -- MICCAI 2024 Challenge Results. https://arxiv.org/abs/2512.18197

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