SAM vs BET: A Comparative Study for Brain Extraction and Segmentation of Magnetic Resonance Images using Deep Learning

Brain extraction is a critical preprocessing step in various neuroimaging studies, particularly enabling accurate separation of brain from non-brain tissue and segmentation of relevant within-brain tissue compartments and structures using Magnetic Resonance Imaging (MRI) data. FSL's Brain Extraction Tool (BET), although considered the current gold standard for automatic brain extraction, presents limitations and can lead to errors such as over-extraction in brains with lesions affecting the outer parts of the brain, inaccurate differentiation between brain tissue and surrounding meninges, and susceptibility to image quality issues. Recent advances in computer vision research have led to the development of the Segment Anything Model (SAM) by Meta AI, which has demonstrated remarkable potential in zero-shot segmentation of objects in real-world scenarios. In the current paper, we present a comparative analysis of brain extraction techniques comparing SAM with a widely used and current gold standard technique called BET on a variety of brain scans with varying image qualities, MR sequences, and brain lesions affecting different brain regions. We find that SAM outperforms BET based on average Dice coefficient, IoU and accuracy metrics, particularly in cases where image quality is compromised by signal inhomogeneities, non-isotropic voxel resolutions, or the presence of brain lesions that are located near (or involve) the outer regions of the brain and the meninges. In addition, SAM has also unsurpassed segmentation properties allowing a fine grain separation of different issue compartments and different brain structures. These results suggest that SAM has the potential to emerge as a more accurate, robust and versatile tool for a broad range of brain extraction and segmentation applications.