{
  "abstract": "Background/Objectives: When a box-prompted segmentation pipeline loses accuracy on new data, the detector proposing the box or a later stage may be responsible; this study measured which. Methods: A real-time detection transformer (RT-DETR) feeding the Segment Anything Model 2.1 was compared with a detector-free model (MedSAM3 with a low-rank adapter) on whole-tumor Dice in 158 patients with glioma: held-out Brain Tumor Segmentation (BraTS) 2020 cases (n = 24), the RHUH-GBM glioblastoma cohort (n = 39), and BraTS-Africa (n = 95, glioma presumed). Giving the segmenter the ground-truth box splits the Dice gap between the systems into a detector-stage term and a residual. Results: The detector-stage term was +0.006 Dice on held-out cases, +0.018 on RHUH-GBM, and +0.091 on BraTS-Africa. Its increase over the held-out value was +0.0854 [95% CI +0.0450, +0.1303] on BraTS-Africa (Holm-adjusted p < 0.001) and, after correction of a preprocessing fault, +0.0120 [−0.0062, +0.0295] on RHUH-GBM, which was not resolved. On BraTS-Africa, it came mainly from slices without a detector box. No residual change was resolved. Conclusions: On BraTS-Africa, the detector stage accounted for most of the increase in the pipeline’s gap; on RHUH-GBM, no increase was resolved. The decomposition should be measured per cohort.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Computer Engineering, , Ankara 06010, Türkiye",
    "Department of Computer Engineering, Turkish Military Academy, National Defence University, Ankara 06420, Türkiye;"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Aykut Kaşkaya"
    },
    {
      "affs": [
        1
      ],
      "name": "Baha Şen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3rsy3cmnqtmqc.bib",
  "cited_by": 0,
  "doi": "10.3390/diagnostics16203391",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13703227/?tool=EBI",
  "id": "3rsy3cmnqtmqc",
  "issns": [
    "2075-4418"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13703227",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R5-920"
    ],
    [
      "openalex",
      "2808|Brain Tumor Detection and Classification"
    ]
  ],
  "openalex": "W7222931274",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13703227/pdf/?tool=EBI",
  "pmcid": "PMC13703227",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/3rsy3cmnqtmqc.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:45Z",
      "native_id": "PMC:PMC13703227",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13703227"
    },
    {
      "first_seen": "2026-10-31T14:21:26Z",
      "native_id": "026bdbadcdca46b8a47639cf2ff3ebd3",
      "source": "doaj",
      "url": "https://doi.org/10.3390/diagnostics16203391"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2808|Brain Tumor Detection and Classification",
      "subfield": "neurology"
    }
  ],
  "title": "Detector-Stage Failures Account for Most of the Increase in the External Deficit of a Box-Prompted Glioma Segmentation Pipeline on BraTS-Africa: A Three-Arm Decomposition Across Two External Cohorts",
  "title_text": "Detector-Stage Failures Account for Most of the Increase in the External Deficit of a Box-Prompted Glioma Segmentation Pipeline on BraTS-Africa: A Three-Arm Decomposition Across Two External Cohorts",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T14:21:26Z",
  "url": "https://research.draconitic.com/paper/3rsy3cmnqtmqc",
  "venue": "Diagnostics (Basel, Switzerland)",
  "versions": []
}