MicroBT: Centroid-Guided Synergistic Learning for Multi-Modal Micro Brain Tumor Segmentation and Counting

Zhenye Lou, Qing Xu, Stefanie Thust, Dorothee P. Auer, Zhen Chen +1

Multi-modal brain tumor segmentation is essential for clinical diagnosis, radiotherapy planning, and longitudinal monitoring. While recent studies have achieved remarkable overall segmentation performance, they rely on overlap-based objectives that inherently favor large regions, causing sub-3 mm micro-lesions to be systematically suppressed during training. Moreover, existing pixel-level segmentation frameworks lack explicit instance-level modeling, leading to unreliable lesion counting that directly impacts clinical staging and therapeutic decisions. To address these challenges, we propose MicroBT, a unified multi-modal framework for micro brain tumor segmentation and counting. Our core insight is that a fundamental geometric property is inherently scale-invariant: regardless of size, each lesion possesses a well-defined centroid. Leveraging this, we first devise a centroid-anchored synergistic paradigm that utilizes predicted centroids as shared anchors to simultaneously condition dense segmentation and instance-level localization. To counteract the tumor size imbalance, we further devise a Volume-Calibrated Loss (VC-Loss) that adaptively amplifies the gradient contribution of…