Background: Automatic multiple sclerosis lesion segmentation is a challenging task. An extensive analysis of the most recent techniques indicates an improvement of the results obtained when using prior knowledge and contextual information.New method: We present BOOST, a knowledge-based approach to automatically segment multiple sclerosis lesions through a voxel by voxel classification. We used the Gentleboost classifier and a set of features, including contextual features, registered atlas probability maps and an outlier map. Results: Results are computed on a set of 45 cases from three different hospitals (15 of each), obtaining a moderate agreement between the manual annotations and the automatically segmented results. Comparison with existing method(s): We quantitatively compared our results with three public state-of-the-art approaches obtaining competitive results and a better overlap with manual annotations. Our approach tends to better segment those cases with high lesion load, while cases with small lesion load are more difficult to accurately segment.Conclusions: We believe BOOST has potential applicability in the clinical practice, although it should be improved in those cases with small lesion load.
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