Abstract To address the issues of the relatively small size of brain tumor image datasets, severe class imbalance, and low precision in existing segmentation algorithms for brain tumor images, this study proposes a two-stage segmentation algorithm integrating convolutional
neural networks (CNNs) and conventional methods. Four modalities of the original magnetic resonance images were first preprocessed separately. Next, preliminary segmentation was performed using an improved U-Net CNN containing deep monitoring, residual structures, dense connection structures,
and dense skip connections. The authors adopted a multiclass Dice loss function to deal with class imbalance and successfully prevented overfitting using data augmentation. The preliminary segmentation results subsequently served as the a priori knowledge for a continuous maximum flow algorithm
for fine segmentation of target edges. Experiments revealed that the mean Dice similarity coefficients of the proposed algorithm in whole tumor, tumor core, and enhancing tumor segmentation were 0.9072, 0.8578, and 0.7837, respectively. The proposed algorithm presents higher accuracy and better
stability in comparison with some of the more advanced segmentation algorithms for brain tumor images.
