The accurate segmentation of brain tumor is significant in clinical practice. Convolutional Neural Network (CNN)-based methods have made great progress in brain tumor segmentation due to powerful local modeling ability. However, brain tumors are frequently pattern-agnostic, i.e. variable in shape, size and location, which can not be effectively matched by traditional CNN-based methods with local and regular receptive fields. To address the above issues, we propose a shape-scale co-awareness network (S2CA-Net) for brain tumor segmentation, which can efficiently learn shape-aware and scale-aware features simultaneously to enhance pattern-agnostic representations. Primarily, three key components are proposed to accomplish the co-awareness of shape and scale. The Local-Global Scale Mixer (LGSM) decouples the extraction of local and global context by adopting the CNN-Former parallel structure, which contributes to obtaining finer hierarchical features. The Multi-level Context Aggregator (MCA) enriches the scale diversity of input patches by modeling global features across multiple receptive fields. The Multi-Scale Attentive Deformable Convolution (MS-ADC) learns the target deformation based on the multiscale inputs, which motivates the network to enforce feature constraints both in terms of scale and shape for optimal feature matching. Overall, LGSM and MCA focus on enhancing the scale-awareness of the network to cope with the size and location variations, while MS-ADC focuses on capturing deformation information for optimal shape matching. Finally, their effective integration prompts the network to perceive variations in shape and scale simultaneously, which can robustly tackle the variations in patterns of brain tumors. The experimental results on BraTS 2019, BraTS 2020, MSD BTS Task and BraTS2023-MEN show that S2CA-Net has superior overall performance in accuracy and efficiency compared to other state-of-the-art methods. Code: https://github.com/jiangyu945/S2CA-Net.
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