A scoping review of automatic and semi-automatic MRI segmentation in human brain imaging

Abstract

Introduction

AI-based segmentation techniques in brain MRI have revolutionized neuroimaging by enhancing the accuracy and efficiency of brain structure analysis. These techniques are pivotal for diagnosing neurodegenerative diseases, classifying psychiatric conditions, and predicting brain age. This scoping review synthesizes current methodologies, identifies key trends, and highlights gaps in the use of automatic and semi-automatic segmentation tools in brain MRI, particularly focusing on their application to healthy populations and clinical utility.

Methods

A scoping review was conducted following Arksey and O'Malley's framework and PRISMA-ScR guidelines. A comprehensive search was performed across six databases for studies published between 2014 and 2024. Studies focused on AI-based brain segmentation in healthy populations, and patients with neurodegenerative diseases, and psychiatric disorders were included, while reviews, case series, and studies without human participants were excluded.

Results

Thirty-two studies were included, employing various segmentation tools and AI models such as convolutional neural networks for segmenting gray matter, white matter, cerebrospinal fluid, and pathological regions. FreeSurfer, which utilizes algorithmic techniques, are also commonly used for automated segmentation. AI models demonstrated high accuracy in brain age prediction, neurodegenerative disease classification, and psychiatric disorder subtyping. Longitudinal studies tracked disease progression, while multimodal approaches integrating MRI with fMRI and PET enhanced diagnostic precision.

Conclusion

AI-based segmentation techniques provide scalable solutions for neuroimaging, advancing personalized brain health strategies and supporting early diagnosis of neurological and psychiatric conditions. However, challenges related to standardization, generalizability, and ethical considerations remain.

Implications for Practice

The integration of AI tools and algorithm-based methods into clinical workflows can enhance diagnostic accuracy and efficiency, but greater focus on model interpretability, standardization of imaging protocols, and patient consent processes is needed to ensure responsible adoption in practice.