{"doi":"10.3389/fneur.2025.1652385","title":"FastSurfer parcellation accuracy after lesion filling in moderate-to-severe traumatic brain injury","abstract":"Objective Focal lesions in T1-weighted (T1-w) magnetic resonance images (MRIs) of patients with moderate-to-severe traumatic brain injury (ms-TBI) can introduce errors during image processing. We tested whether errors in FastSurfer cortical parcellation could be reduced using lesion filling (virtual brain grafting (VBG)). Methods T1-w MRIs from 140 healthy controls and 14 ms-TBI patients were shared within the ENIGMA TBI working group. A “ground truth” set of 140 lesion-free images was created by registering 10 healthy controls (HCs) onto each of 14 ms-TBI images. Masks indexing focal lesions (small [38 mm 3 ] unilateral to large [164,291 mm 3 ] bilateral) were projected onto lesion-free images, creating 140 synthetically lesioned images. Lesioned images underwent VBG filling to replace lesioned regions with simulated healthy brain tissue, creating 140 VBG-filled images. To calculate parcellation accuracy, paired sample t- tests of mean Dice similarity coefficients (DSCs) and percent volume differences (PVDs) for lesioned and VBG-filled images were compared to lesion-free images. Results Parcellations from lesioned images (DSC M = 0.93, SD = 0.03; PVD M = −0.40, SD = 1.7) unexpectedly had significantly higher DSCs [ t (111) = 19.5, p < 0.001] and lower PVDs [ t (111) = 11.3, p < 0.001] than VBG-filled images (DSC M = 0.81, SD = 0.07; PVD M = −9.03, SD = 7.72). Interpretation Parcellations from lesioned images were more accurate (than VBG-filled images) than lesion-free ground truth images. While likely due to a high frequency of smaller focal lesions in our sample, these results could suggest that FastSurfer parcellation may be robust in the presence of such lesions.","journal":"Frontiers in Neurology","year":2025,"id":537640,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.917,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":783876,"name":"Emily Dennis","orcid":"0000-0002-9634-7767","position":1,"is_corresponding":false},{"id":337523,"name":"Frank G. Hillary","orcid":"0000-0002-1427-0218","position":2,"is_corresponding":false},{"id":285281,"name":"Elisabeth A. Wilde","orcid":"0000-0002-9839-4428","position":3,"is_corresponding":false},{"id":109366,"name":"Carrie Esopenko","orcid":"0000-0001-8607-5633","position":4,"is_corresponding":false},{"id":106609,"name":"Ekaterina Dobryakova","orcid":"0000-0002-6005-2115","position":5,"is_corresponding":false},{"id":337510,"name":"Andrei Irimia","orcid":"0000-0002-9254-9388","position":6,"is_corresponding":false},{"id":1423899,"name":"Ahmed M. Radwan","orcid":null,"position":7,"is_corresponding":false},{"id":880599,"name":"Phoebe Imms","orcid":"0000-0002-7205-4177","position":8,"is_corresponding":false},{"id":908401,"name":"Adam Clemente","orcid":"0000-0002-4742-7015","position":9,"is_corresponding":false},{"id":744534,"name":"Paul Beech","orcid":"0000-0003-3871-3682","position":10,"is_corresponding":false},{"id":1423900,"name":"Alex Burmester","orcid":null,"position":11,"is_corresponding":false},{"id":109358,"name":"Karen Caeyenberghs","orcid":"0000-0001-7009-6843","position":12,"is_corresponding":false},{"id":1423901,"name":"D. Juan F. Domínguez","orcid":null,"position":13,"is_corresponding":false},{"id":908402,"name":"Evelyn Deutscher","orcid":"0000-0002-6846-4456","position":0,"is_corresponding":true}],"reference_count":52,"raw_metadata":null,"created_at":"2026-07-19T02:52:12.997494Z","pmid":"41451415","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}