  We present an efficient deep learning approach for the challenging task of
tumor segmentation in multisequence MR images. In recent years, Convolutional
Neural Networks (CNN) have achieved state-of-the-art performances in a large
variety of recognition tasks in medical imaging. Because of the considerable
computational cost of CNNs, large volumes such as MRI are typically processed
by subvolumes, for instance slices (axial, coronal, sagittal) or small 3D
patches. In this paper we introduce a CNN-based model which efficiently
combines the advantages of the short-range 3D context and the long-range 2D
context. To overcome the limitations of specific choices of neural network
architectures, we also propose to merge outputs of several cascaded 2D-3D
models by a voxelwise voting strategy. Furthermore, we propose a network
architecture in which the different MR sequences are processed by separate
subnetworks in order to be more robust to the problem of missing MR sequences.
Finally, a simple and efficient algorithm for training large CNN models is
introduced. We evaluate our method on the public benchmark of the BRATS 2017
challenge on the task of multiclass segmentation of malignant brain tumors. Our
method achieves good performances and produces accurate segmentations with
median Dice scores of 0.918 (whole tumor), 0.883 (tumor core) and 0.854
(enhancing core). Our approach can be naturally applied to various tasks
involving segmentation of lesions or organs.
