Many deep learning based methods have been proposed for brain tumor segmentation. Most studies focus on deep network internal structure to improve the segmentation accuracy, while valuable external information, such as normal brain appearance, is often ignored. Inspired by the fact that radiologists often screen lesion regions with normal appearance as reference in mind, in this paper, we propose a novel deep framework for brain tumor segmentation, where normal brain images are adopted as reference to compare with tumor brain images in a learned feature space. In this way, features at tumor regions, i.e., tumor-related features, can be highlighted and enhanced for accurate tumor segmentation. It is known that routine tumor brain images are multimodal, while normal brain images are often monomodal. This causes the feature comparison a big issue, i.e., multimodal vs. monomodal. To this end, we present a new feature alignment module (FAM) to make the feature distribution of monomodal normal brain images consistent/inconsistent with multimodal tumor brain images at normal/tumor regions, making the feature comparison effective. Both public (BraTS2022) and in-house tumor brain image datasets are used to evaluate our framework. Experimental results demonstrate that for both datasets, our framework can effectively improve the segmentation accuracy and outperforms the state-of-the-art segmentation methods. Codes are available at https://github.com/hb-liu/Normal-Brain-Boost-Tumor-Segmentation.

Deep learning based multi-atlas segmentation (DL-MA) has achieved the state-of-the-art performance in many medical image segmentation tasks, e.g., brain parcellation. In DL-MA methods, atlas-target correspondence is the key for accurate segmentation. In most existing DL-MA methods, such correspondence is usually established using traditional or deep learning based registration methods at image level with no further feature level adaption. This could cause possible atlas-target feature inconsistency. As a result, the information from atlases often has limited positive and even counteractive impact on the final segmentation results. To tackle this issue, in this paper, we propose a new DL-MA framework, where a novel differentiable atlas feature warping module with a new smooth regularization term is presented to establish feature level atlas-target correspondence. Comparing with the existing DL-MA methods, in our framework, atlas features containing anatomical prior knowledge are more relevant to the target image feature, leading the final segmentation results to a high accuracy level. We evaluate our framework in the context of brain parcellation using two public MR brain image datasets: LPBA40 and NIREP-NA0. The experimental results demonstrate that our framework outperforms both traditional multi-atlas segmentation (MAS) and state-of-the-art DL-MA methods with statistical significance. Further ablation studies confirm the effectiveness of the proposed differentiable atlas feature warping module.