Brain-Shift: Unsupervised Pseudo-Healthy Brain Synthesis for Novel
  Biomarker Extraction in Chronic Subdural Hematoma
Baris Imre Elina Thibeau-Sutre Jorieke Reimer Kuan Kho Jelmer M. Wolterink
Chronic subdural hematoma (cSDH) is a common neurological condition
characterized by the accumulation of blood between the brain and the dura
mater. This accumulation of blood can exert pressure on the brain, potentially
leading to fatal outcomes. Treatment options for cSDH are limited to invasive
surgery or non-invasive management. Traditionally, the midline shift,
hand-measured by experts from an ideal sagittal plane, and the hematoma volume
have been the primary metrics for quantifying and analyzing cSDH. However,
these approaches do not quantify the local 3D brain deformation caused by cSDH.
We propose a novel method using anatomy-aware unsupervised diffeomorphic
pseudo-healthy synthesis to generate brain deformation fields. The deformation
fields derived from this process are utilized to extract biomarkers that
quantify the shift in the brain due to cSDH. We use CT scans of 121 patients
for training and validation of our method and find that our metrics allow the
identification of patients who require surgery. Our results indicate that
automatically obtained brain deformation fields might contain prognostic value
for personalized cSDH treatment. Our implementation is available on:
github.com/Barisimre/brain-morphing