Strategies to Improve the Robustness and Generalizability of Deep Learning Segmentation and Classification in Neuroimaging.

Artificial Intelligence (AI) and deep learning models have revolutionized diagnosis, prognostication, and treatment planning by extracting complex patterns from medical images, enabling more accurate, personalized, and timely clinical decisions. Despite its promise, challenges such as image heterogeneity across different centers, variability in acquisition protocols and scanners, and sensitivity to artifacts hinder the reliability and clinical integration of deep learning models. Addressing these issues is critical for ensuring accurate and practical AI-powered neuroimaging applications. We reviewed and summarized the strategies for improving the robustness and generalizability of deep learning models for the segmentation and classification of neuroimages. This review follows a structured protocol, comprehensively searching Google Scholar, PubMed, and Scopus for studies on neuroimaging, task-specific applications, and model attributes. Peer-reviewed, English-language studies on brain imaging were included. The extracted data were analyzed to evaluate the implementation and effectiveness of these techniques. The study identifies key strategies to enhance deep learning in neuroimaging, including regularization, data augmentation, transfer learning, and uncertainty estimation. These approaches address major challenges such as data variability and domain shifts, improving model robustness and ensuring consistent performance across diverse clinical settings. The technical strategies summarized in this review can enhance the robustness and generalizability of deep learning models for segmentation and classification to improve their reliability for real-world clinical practice.