Although machine learning (ML) has shown promise across disciplines, out-of-sample generalizability is concerning. This is currently addressed by sharing multi-site data, but such centralization is challenging/infeasible to scale due to various limitations. Federated ML (FL) provides an alternative paradigm for accurate and generalizable ML, by only sharing numerical model updates. Here we present the largest FL study to-date, involving data from 71 sites across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, reporting the largest such dataset in the literature (n = 6, 314). We demonstrate a 33% delineation improvement for the surgically targetable tumor, and 23% for the complete tumor extent, over a publicly trained model. We anticipate our study to: 1) enable more healthcare studies informed by large diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further analyses for glioblastoma by releasing our consensus model, and 3) demonstrate the FL effectiveness at such scale and task-complexity as a paradigm shift for multi-site collaborations, alleviating the need for data-sharing.

Alberta Machine Intelligence Institute Edmonton AB Canada

Athinoula A Martinos Center for Biomedical Imaging Massachusetts General Hospital Charlestown MA USA

Biomedical Imaging Group Rotterdam Department of Radiology and Nuclear Medicine Erasmus MC University Medical Centre Rotterdam Rotterdam Netherlands

Case Comprehensive Cancer Center Cleveland OH USA

Case Western Reserve University Cleveland OH USA

Catalan Institute of Oncology Badalona Spain

Center for Biomedical Image Computing and Analytics University of Pennsylvania Philadelphia PA USA

Center for Biomedical Informatics and Information Technology National Cancer Institute National Institute of Health Bethesda MD USA

Center for Global Health Perelman School of Medicine University of Pennsylvania Philadelphia PA USA

Center for Research and Innovation American College of Radiology Philadelphia PA USA

Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke Sherbrooke QC Canada

Centre for Biomedical Image Analysis Faculty of Informatics Masaryk University Brno Czech Republic

Clínica Imbanaco Grupo Quirón Salud Cali Colombia

Clinical Cooperation Unit Neuropathology German Cancer Consortium Heidelberg Germany

Clinical Radiology Laboratory Department of Medicine University of Patras Patras Greece

Clinix Healthcare Lagos Lagos Nigeria

College of Medicine and Public Health Flinders University Bedford Park SA Australia

Computational Oncology Group Institute for Global Health Innovation Imperial College London London UK

Consorci MAR Parc de Salut de Barcelona Catalonia Spain

Data Science Institute American College of Radiology Reston VA USA

Department of Biomedical and Molecular Sciences Queen's University Kingston ON Canada

Department of Biomedical Informatics Stony Brook University Stony Brook New York USA

Department of Biophysics Faculty of Medicine Masaryk University Brno Czech Republic

Department of Computational Medicine and Bioinformatics University of Michigan Ann Arbor MI USA

Department of Computer Science Université de Sherbrooke Sherbrooke QC Canada

Department of Computer Science Vanderbilt University Nashville TN USA

Department of Computing Imperial College London London UK

Department of Diagnostic and Interventional Neuroradiology School of Medicine Klinikum rechts der Isar Technical University of Munich Munich Germany

Department of Diagnostic Radiology University of Texas MD Anderson Cancer Center Houston TX USA

Department of Electrical and Computer Engineering University of Patras Patras Greece

Department of Electrical and Computer Engineering Whiting School of Engineering Johns Hopkins University Baltimore MD USA

Department of Electrical Engineering Qazvin Branch Islamic Azad University Qazvin Iran

Department of Industrial and Systems Engineering Department of Radiation Oncology University of Iowa Iowa City IA USA

Department of Industrial and Systems Engineering University of Iowa Iowa USA

Department of Informatics Technical University of Munich Munich Bavaria Germany

Department of Informatics Universidade Federal do Paraná Curitiba Paraná Brazil

Department of Medical Physics School of Medicine and Public Health University of Wisconsin Madison WI USA

Department of Neuro Oncology H Lee Moffitt Cancer Center and Research Institute Tampa FL USA

Department of Neuro Oncology University of Patras Patras Greece

Department of Neuroimaging and Interventional Radiology National Institute of Mental Health and Neurosciences Bangalore Karnataka India

Department of Neurological Surgery University Hospitals Seidman Cancer Center Cleveland OH USA

Department of Neurology Baylor College of Medicine Houston TX USA

Department of Neurology Brain Tumor Center Erasmus MC Cancer Institute Rotterdam Netherlands

Department of Neurology Clinical Neuroscience Center University Hospital Zurich and University of Zurich Zurich Switzerland

Department of Neurooncology Neuromed Campus Kepler University Hospital Linz Linz Austria

Department of Neuropathology Heidelberg University Hospital Heidelberg Germany

Department of Neuroradiology Clinical Neuroscience Center University Hospital Zurich and University of Zurich Zurich Switzerland

Department of Neuroradiology Heidelberg University Hospital Heidelberg Germany

Department of Neuroradiology Ruskin Wing King's College Hospital NHS Foundation Trust London UK

Department of Neuroradiology University of Michigan Ann Arbor MI USA

Department of NeuroRadiology University of Patras Patras Greece

Department of Neurosurgery Anschutz Medical Campus University of Colorado Aurora CO USA

Department of Neurosurgery Brain Tumor Center Erasmus MC University Medical Centre Rotterdam Rotterdam Netherlands

Department of Neurosurgery Case Western Reserve University School of Medicine Cleveland OH USA

Department of Neurosurgery Faculty of Medicine Masaryk University Brno and University Hospital and Czech Republic Brno Czech Republic

Department of Neurosurgery NYU Grossman School of Medicine New York NY USA

Department of Neurosurgery University of Patras Patras Greece

Department of Neurosurgery Vanderbilt University Medical Center Nashville TN USA

Department of Nuclear Medicine and Radiobiology Sherbrooke Molecular Imaging Centre Université de Sherbrooke Sherbrooke QC Canada

Department of Oncology Queen's University Kingston ON Canada

Department of Pathology and Laboratory Medicine Perelman School of Medicine University of Pennsylvania Philadelphia PA USA

Department of Pathology Brain Tumor Center Erasmus MC Cancer Institute Rotterdam Netherlands

Department of Quantitative Biomedicine University of Zurich Zurich Switzerland

Department of Radiation Oncology Christiana Care Health System Philadelphia PA USA

Department of Radiation Oncology Henry Ford Health System Detroit MI USA

Department of Radiation Oncology Icahn School of Medicine at Mount Sinai New York NY USA

Department of Radiation Oncology Sidney Kimmel Cancer Center Thomas Jefferson University Philadelphia PA USA

Department of Radiation Oncology Stony Brook University Stony Brook NY USA

Department of Radiation Oncology The James Cancer Hospital and Solove Research Institute The Ohio State University Comprehensive Cancer Center Columbus OH USA

Department of Radiation Oncology University of Iowa Iowa City IA USA

Department of Radiation Oncology University of Maryland Baltimore MD USA

Department of Radiation Oncology University of Patras Patras Greece

Department of Radiological Sciences David Geffen School of Medicine University of California Los Angeles Los Angeles CA USA

Department of Radiology and Biomedical Imaging University of California San Francisco San Francisco CA USA

Department of Radiology and Nuclear Medicine Erasmus MC University Medical Centre Rotterdam Rotterdam Netherlands

Department of Radiology and Nuclear Medicine Faculty of Medicine Masaryk University Brno and University Hospital Brno Brno Czech Republic

Department of Radiology Asan Medical Center Seoul South Korea

Department of Radiology Baylor College of Medicine Houston TX USA

Department of Radiology Brigham and Women's Hospital Harvard Medical School Boston MA USA

Department of Radiology H Lee Moffitt Cancer Center and Research Institute Tampa FL USA

Department of Radiology Hospital de Clínicas da Universidade Federal do Paraná Curitiba Paraná Brazil

Department of Radiology Imperial College NHS Healthcare Trust London UK

Department of Radiology Josep Trueta University Hospital Girona Spain

Department of Radiology Muhammad Abdullahi Wase Teaching Hospital Kano Nigeria

Department of Radiology Netherlands Cancer Institute Amsterdam Netherlands

Department of Radiology Neuroradiology Division University of Pittsburgh Pittsburgh PA USA

Department of Radiology NYU Grossman School of Medicine New York NY USA

Department of Radiology Obafemi Awolowo University Ile Ife Ile Ife Osun Nigeria

Department of Radiology Perelman School of Medicine University of Pennsylvania Philadelphia PA USA

Department of Radiology School of Medicine and Public Health University of Wisconsin Madison WI USA

Department of Radiology Sidney Kimmel Cancer Center Thomas Jefferson University Philadelphia PA USA

Department of Radiology Stony Brook University Stony Brook NY USA

Department of Radiology University College Hospital Ibadan Oyo Nigeria

Department of Radiology University Hospitals Cleveland Cleveland OH USA

Department of Radiology University of Washington Seattle WA USA

Department of Radiology Washington University in St Louis St Louis MO USA

Division of Medical Image Computing German Cancer Research Center Heidelberg Germany

Division of Neuroradiology and Neurointerventional Radiology Department of Radiology MedStar Georgetown University Hospital Washington DC USA

Division of Neurosurgery and Neuro Oncology Faculty of Medicine and Health Science Université de Sherbrooke Sherbrooke QC Canada

Division of Surgery and Perioperative Medicine Flinders Medical Centre Bedford Park SA Australia

Electrical and Computer Engineering Vanderbilt University Nashville TN USA

Escuela Superior Politecnica del Litoral Guayaquil Guayas Ecuador

Federal Institute of São Paulo Campinas São Paulo Brazil

GROW School of Oncology and Developmental Biology Maastricht Netherlands

Image Based Biomedical Modeling Department of Informatics Technical University of Munich Munich Germany

Innovation Center for Biomedical Informatics Georgetown University Washington DC USA

Institute of Biomedical Engineering Department of Engineering Science University of Oxford Oxford UK

Institute of Computing University of Campinas Campinas São Paulo Brazil

Institute of Diagnostic and Interventional Neuroradiology RKH Klinikum Ludwigsburg Ludwigsburg Germany

Institute of Neuroradiology Neuromed Campus Kepler University Hospital Linz Linz Austria

Instituto de Neurologia de Curitiba Curitiba Paraná Brazil

Intel Corporation Santa Clara CA USA

Leeds Teaching Hospitals Trust Department of Radiology Leeds UK

Luxembourg Center of Neuropathology Laboratoire National De Santé Luxembourg Luxembourg

MD Anderson Cancer Center University of Texas Houston TX USA

National Cancer Institute National Institute of Health Division of Cancer Epidemiology and Genetics Bethesda MD USA

Neosoma Inc Groton MA USA

Netherlands Cancer Institute Amsterdam Netherlands

Neurology Clinic Heidelberg University Hospital Heidelberg Germany

NORLUX Neuro Oncology Laboratory Department of Cancer Research Luxembourg Institute of Health Luxembourg Luxembourg

Pattern Analysis and Learning Group Department of Radiation Oncology Heidelberg University Hospital Heidelberg Germany

Public Health Sciences Henry Ford Health System Detroit MI USA

School of Biomedical Engineering and Imaging Sciences King's College London London UK

School of Computing Queen's University Kingston ON Canada

School of Electronic Engineering and Computer Science Queen Mary University of London London UK

Scientific Data Group Oak Ridge National Laboratory Oak Ridge TN USA

Sidney Kimmel Medical College Thomas Jefferson University Philadelphia PA USA

SJTU Ruijin UIH Institute for Medical Imaging Technology Ruijin Hospital Shanghai Jiao Tong University School of Medicine 200025 Shanghai China

Sociedad de Lucha Contral el Cancer SOLCA Guayaquil Ecuador Guayaquil Ecuador

South Australia Medical Imaging Flinders Medical Centre Bedford Park SA Australia

Stoke Mandeville Hospital Mandeville Road Aylesbury UK

Support Center for Advanced Neuroimaging University Institute of Diagnostic and Interventional Neuroradiology University Hospital Bern Inselspital University of Bern Bern Switzerland

Symbiosis Center for Medical Image Analysis Symbiosis International University Pune Maharashtra India

The Chinese University of Hong Kong Hong Kong China

The Clatterbridge Cancer Centre NHS Foundation Trust Pembroke Place Liverpool UK

The Faculty of Arts and Sciences Queen's University Kingston ON Canada

The Malone Center for Engineering in Healthcare The Whiting School of Engineering Johns Hopkins University Baltimore MD USA

The Russell H Morgan Department of Radiology and Radiological Science Johns Hopkins University School of Medicine Baltimore MD USA

The University of Edinburgh Edinburgh UK

Translation Radiomics Department of Cancer Research Luxembourg Institute of Health Luxembourg Luxembourg

TranslaTUM Klinikum rechts der Isar Munich Germany

UCLA Brain Tumor Imaging Laboratory Center for Computer Vision and Imaging Biomarkers Department of Radiological Sciences David Geffen School of Medicine University of California Los Angeles Los Angeles CA USA

UCLA Neuro Oncology Program Department of Neurology David Geffen School of Medicine University of California Los Angeles Los Angeles CaA USA

Universidad Católica de Cuenca Cuenca Ecuador

Universidad de Concepción Concepción Biobío Chile

Universidad del Valle Cali Colombia

University of Alabama in Birmingham Birmingham AL USA

University of Alberta Edmonton AB Canada

University of Bern Bern Switzerland

University of Cairo School of Medicine Giza Egypt

University of Pittsburgh Medical Center Pittsburgh PA USA

University of Texas Southwestern Medical Center Dallas TX USA

Yonsei University College of Medicine Seoul Korea

Erratum v

Nat Commun. 2023 Jan 26;14(1):436. doi: 10.1038/s41467-023-36188-7. PubMed

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Advanced MR Techniques for Preoperative Glioma Characterization: Part 2