# Knowledge-Guided Brain Tumor Segmentation via Synchronized Visual-Semantic-Topological Prior Fusion

arXiv: https://arxiv.org/abs/2507.08574 · HTML: https://mlsanity.com/paper/2507.08574/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 29 of its 62 references that are in the map.
- First posted on arXiv 11 Jul 2025.

## Builds on (most cited first, 29 of 29)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [Graph Attention Networks](https://mlsanity.com/paper/1710.10903/) (2017)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [The RSNA-ASNR-MICCAI BraTS 2021 Benchmark on Brain Tumor Segmentation and Radiogenomic Classification](https://mlsanity.com/paper/2107.02314/) (2021)
- [MONAI: An open-source framework for deep learning in healthcare](https://mlsanity.com/paper/2211.02701/) (2022)
- [Making the Most of Text Semantics to Improve Biomedical Vision--Language Processing](https://mlsanity.com/paper/2204.09817/) (2022)
- [3D MRI brain tumor segmentation using autoencoder regularization](https://mlsanity.com/paper/1810.11654/) (2018)
- [SegMamba: Long-range Sequential Modeling Mamba For 3D Medical Image Segmentation](https://mlsanity.com/paper/2401.13560/) (2024)
- [TransBTS: Multimodal Brain Tumor Segmentation Using Transformer](https://mlsanity.com/paper/2103.04430/) (2021)
- [Metrics reloaded: Recommendations for image analysis validation](https://mlsanity.com/paper/2206.01653/) (2022)
- [A Topological Loss Function for Deep-Learning based Image Segmentation using Persistent Homology](https://mlsanity.com/paper/1910.01877/) (2019)
- [HeMIS: Hetero-Modal Image Segmentation](https://mlsanity.com/paper/1607.05194/) (2016)
- [Fast Unsupervised Brain Anomaly Detection and Segmentation with Diffusion Models](https://mlsanity.com/paper/2206.03461/) (2022)
- [NestedFormer: Nested Modality-Aware Transformer for Brain Tumor Segmentation](https://mlsanity.com/paper/2208.14876/) (2022)
- [CKD-TransBTS: Clinical Knowledge-Driven Hybrid Transformer with Modality-Correlated Cross-Attention for Brain Tumor Segmentation](https://mlsanity.com/paper/2207.07370/) (2022)
- [ASC-Net : Adversarial-based Selective Network for Unsupervised Anomaly Segmentation](https://mlsanity.com/paper/2103.03664/) (2021)
- [Analysis of the BraTS 2023 Intracranial Meningioma Segmentation Challenge](https://mlsanity.com/paper/2405.09787/) (2024)
- [ConTEXTual Net: A Multimodal Vision-Language Model for Segmentation of Pneumothorax](https://mlsanity.com/paper/2303.01615/) (2023)
- [Leveraging the Mahalanobis Distance to enhance Unsupervised Brain MRI Anomaly Detection](https://mlsanity.com/paper/2407.12474/) (2024)
- [Deep Class-Specific Affinity-Guided Convolutional Network for Multimodal Unpaired Image Segmentation](https://mlsanity.com/paper/2101.01513/) (2021)
- [SEG-SAM: Semantic-Guided SAM for Unified Medical Image Segmentation](https://mlsanity.com/paper/2412.12660/) (2024)
- [From Gaze to Insight: Bridging Human Visual Attention and Vision Language Model Explanation for Weakly-Supervised Medical Image Segmentation](https://mlsanity.com/paper/2504.11368/) (2025)
- [FDiff-Fusion:Denoising diffusion fusion network based on fuzzy learning for 3D medical image segmentation](https://mlsanity.com/paper/2408.02075/) (2024)
- [Exploring Adult Glioma through MRI: A Review of Publicly Available Datasets to Guide Efficient Image Analysis](https://mlsanity.com/paper/2409.00109/) (2024)
- [Understanding implementation pitfalls of distance-based metrics for image segmentation](https://mlsanity.com/paper/2410.02630/) (2024)

## Abstract (arXiv)

Background: Brain tumor segmentation requires precise delineation of hierarchical structures from multi-sequence MRI. However, existing deep learning methods primarily rely on visual features, showing insufficient discriminative power in ambiguous boundary regions. Moreover, they lack explicit integration of medical domain knowledge such as anatomical semantics and geometric topology. Methods: We propose a knowledge-guided framework, Synchronized Tri-modal Prior Fusion (STPF), that explicitly integrates three heterogeneous knowledge priors: pathology-driven differential features (T1ce-T1, T2-FLAIR, T1/T2) encoding contrast patterns; unsupervised semantic descriptions transformed into voxel-level guidance via spatialization operators; and geometric constraints extracted through persistent homology analysis. A dual-level fusion architecture dynamically allocates prior weights at the voxel level based on confidence and at the sample level through hypernetwork-generated conditional vectors. Furthermore, nested output heads structurally ensure the hierarchical constraint ET subset TC subset WT. Results: STPF achieves a mean Dice coefficient of 0.868 on the BraTS 2020 dataset, surpassing the best baseline by 2.6 percentage points (3.09% relative improvement). Notably, five-fold cross-validation yields coefficients of variation between 0.23% and 0.33%, demonstrating stable performance. Additionally, ablation experiments show that removing topological and semantic priors leads to performance degradation of 2.8% and 3.5%, respectively. Conclusions: By explicitly integrating medical knowledge priors - anatomical semantics and geometric constraints - STPF improves segmentation accuracy in ambiguous boundary regions while demonstrating generalization capability and clinical deployment potential.