Multi-BOUNTI deep learning pipeline enables rapid automated multi-lobe segmentation of fetal and neonatal T2w brain MRI

Regional volumetric assessment of perinatal brain development is currently limited by the lack of consistent high quality multi-regional segmentation methods applicable to both fetal and neonatal MRI. We present Multi-BOUNTI, a deep learning pipeline for automated multi-lobe segmentation of fetal and neonatal T2w brain MRI. The method is based on a dedicated 43-label parcellation protocol and a 3D Attention U-Net trained on brain MRI datasets of subjects spanning 21-44 weeks gestational/postmenstrual age. The pipeline integrates preprocessing, segmentation and volumetric analysis, and was evaluated on independent datasets, demonstrating fast (<10 min/case) and accurate performance with high agreement to manually refined labels. We demonstrate the application of the framework with 267 fetal and 593 neonatal MRI datasets from the developing Human Connectome Project without reported clinically significant brain anomalies to derive normative volumetric growth models across 21-44 weeks GA/PMA. These models were used to characterise developmental trajectories, assess differences between fetal and preterm neonatal cohorts, and analyse longitudinal changes. The resulting normative models were integrated into an automated reporting framework enabling subject-specific volumetric assessment via centiles and z-scores. Multi-BOUNTI provides a unified and scalable approach for perinatal brain segmentation and volumetry, supporting large-scale studies and facilitating future clinical translation. The full pipeline is publicly available at https://github.com/SVRTK/perinatal-brain-mri-analysis.