Abstract

Brain vessel status is a promising biomarker for better prevention and treatment in cerebrovascular disease. However, classic rule-based vessel segmentation algorithms need to be hand-crafted and are insufficiently validated. A specialized deep learning method—the U-net—is a promising alternative. Using labeled data from 66 patients with cerebrovascular disease, the U-net framework was optimized and evaluated with three metrics: Dice coefficient, 95% Hausdorff distance (95HD) and average Hausdorff distance (AVD). The model performance was compared with the traditional segmentation method of graph-cuts. Training and reconstruction was performed using 2D patches. A full and a reduced architecture with less parameters were trained. We performed both quantitative and qualitative analyses. The U-net models yielded high performance for both the full and the reduced architecture: A Dice value of ~0.88, a 95HD of ~47 voxels and an AVD of ~0.4 voxels. The visual analysis revealed excellent performance in large vessels and sufficient performance in small vessels. Pathologies like cortical laminar necrosis and a rete mirabile led to limited segmentation performance in few patients. The U-net outperfomed the traditional graph-cuts method (Dice ~0.76, 95HD ~59, AVD ~1.97). Our work highly encourages the development of clinically applicable segmentation tools based on deep learning. Future works should focus on improved segmentation of small vessels and methodologies to deal with specific pathologies.

Highlights

  • Stroke is a world disease with extreme impact on patients and healthcare systems

  • We identified three final models for performance comparison: Since we based our assessment on three different metrics—the Dice coefficient, the 95% Hausdorff distance (95HD) and the average Hausdorff distance (AVD)—we chose a model that optimized each of the metrics based on the validation set

  • The U-net architecture resulted in 31,377,793 parameters, while the half U-net resulted in 7,846,081 parameters

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Summary

Introduction

Stroke is a world disease with extreme impact on patients and healthcare systems. 15 million people suffer from an ischemic stroke each year worldwide. A third of the patients die, making stroke a leading cause of death. Since stroke is a cerebrovascular disease, more detailed information about arterial vessel status may play a crucial role for both the. U-Net Vessel Extraction in Cerebrovascular Disease prevention of stroke and the improvement of stroke therapy. It has potential to become a biomarker for new personalized medicine approaches for stroke prevention and treatment (Hinman et al, 2017). Considering that vessel imaging is a routine procedure in the clinical setting, vessel information could be integrated in the clinical workflow, if segmentations are available and processed

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