Ischemic Stroke Lesion Segmentation Research Articles

Ischemic stroke infarct segmentation model based on depthwise separable convolution for multimodal magnetic resonance imaging

Magnetic resonance imaging (MRI) plays a crucial role in the diagnosis of ischemic stroke. Accurate segmentation of the infarct is of great significance for selecting intervention treatment methods and evaluating the prognosis of patients. To address the issue of poor segmentation accuracy of existing methods for multiscale stroke lesions, a novel encoder-decoder architecture network based on depthwise separable convolution is proposed. Firstly, this network replaces the convolutional layer modules of the U-Net with redesigned depthwise separable convolution modules. Secondly, an modified Atrous spatial pyramid pooling (MASPP) is introduced to enlarge the receptive field and enhance the extraction of multiscale features. Thirdly, an attention gate (AG) structure is incorporated at the skip connections of the network to further enhance the segmentation accuracy of multiscale targets. Finally, Experimental evaluations are conducted using the ischemic stroke lesion segmentation 2022 challenge (ISLES2022) dataset. The proposed algorithm in this paper achieves Dice similarity coefficient (DSC), Hausdorff distance (HD), sensitivity (SEN), and precision (PRE) scores of 0.816 5, 3.668 1, 0.889 2, and 0.894 6, respectively, outperforming other mainstream segmentation algorithms. The experimental results demonstrate that the method in this paper effectively improves the segmentation of infarct lesions, and is expected to provide a reliable support for clinical diagnosis and treatment.

SrSNet: Accurate segmentation of stroke lesions by a two-stage segmentation framework with asymmetry information

Ischemic stroke is a common neurological disease with a high mortality rate. Accurate stroke segmentation is crucial to evaluating patients’ disease outcomes. Stroke segmentation suffers from variable lesion size and noise interference due to similar image contrast characteristics of tissue structures. In this work, we propose a novel two-stage framework named Segmentation–reSegmentation Net (SrSNet) that mainly considers the bilateral symmetric comparison of brain hemispheres to locate pathological abnormalities. The whole framework includes two stages, the coarse segmentation stage and the fine segmentation stage. In the coarse segmentation stage, the brain images are first divided into three patches according to their spatial information to learn the local-level feature and then fed into a 2D Triplet Multi-scale Symmetric Transformer (TMSFormer) with a feature fusion module. This module facilitates the TMSFormer to generate detailed coarse segmentation results. In the fine segmentation stage, we refine the coarse segmentations with a 2D ResUNet. Extensive experiments are conducted using the two ischemic stroke lesion segmentation datasets, and the results are compared with other advanced models. Experiment results on two datasets show that SrSNet achieves state-of-the-art (SOTA) performance. Moreover, on the Ischemic Stroke Lesion Segmentation 2022 (ISLES’22) dataset, the recall score for stroke lesions that the maximum cross-sectional diameter is larger than 5 cm is 83.80%, and the recall score for strokes that the number of lesions of more than five is 79.05%. Overall, our method provides a potentially successful tool for improving the diagnosis of ischemic stroke.

Hybrid CNN-Transformer Network With Circular Feature Interaction for Acute Ischemic Stroke Lesion Segmentation on Non-Contrast CT Scans.

Lesion segmentation is a fundamental step for the diagnosis of acute ischemic stroke (AIS). Non-contrast CT (NCCT) is still a mainstream imaging modality for AIS lesion measurement. However, AIS lesion segmentation on NCCT is challenging due to low contrast, noise and artifacts. To achieve accurate AIS lesion segmentation on NCCT, this study proposes a hybrid convolutional neural network (CNN) and Transformer network with circular feature interaction and bilateral difference learning. It consists of parallel CNN and Transformer encoders, a circular feature interaction module, and a shared CNN decoder with a bilateral difference learning module. A new Transformer block is particularly designed to solve the weak inductive bias problem of the traditional Transformer. To effectively combine features from CNN and Transformer encoders, we first design a multi-level feature aggregation module to combine multi-scale features in each encoder and then propose a novel feature interaction module containing circular CNN-to-Transformer and Transformer-to-CNN interaction blocks. Besides, a bilateral difference learning module is proposed at the bottom level of the decoder to learn the different information between the ischemic and contralateral sides of the brain. The proposed method is evaluated on three AIS datasets: the public AISD, a private dataset and an external dataset. Experimental results show that the proposed method achieves Dices of 61.39% and 46.74% on the AISD and the private dataset, respectively, outperforming 17 state-of-the-art segmentation methods. Besides, volumetric analysis on segmented lesions and external validation results imply that the proposed method is potential to provide support information for AIS diagnosis.

Robust Ensemble of Two Different Multimodal Approaches to Segment 3D Ischemic Stroke Segmentation Using Brain Tumor Representation Among Multiple Center Datasets.

Ischemic stroke segmentation at an acute stage is vital in assessing the severity of patients' impairment and guiding therapeutic decision-making for reperfusion. Although many deep learning studies have shown attractive performance in medical segmentation, it is difficult to use these models trained on public data with private hospitals' datasets. Here, we demonstrate an ensemble model that employs two different multimodal approaches for generalization, a more effective way to perform on external datasets. First, after we jointly train a segmentation model on diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) MR modalities, the model is inferred on the DWI images. Second, a channel-wise segmentation model is trained by concatenating the DWI and ADC images as input, and then is inferred using both MR modalities. Before training with ischemic stroke data, we utilized BraTS 2021, a public brain tumor dataset, for transfer learning. An extensive ablation study evaluates which strategy learns better representations for ischemic stroke segmentation. In our study, nnU-Net well-known for robustness is selected as our baseline model. Our proposed method is evaluated on three different datasets: the Asan Medical Center (AMC) I and II, and the 2022 Ischemic Stroke Lesion Segmentation (ISLES). Our experiments are widely validated over a large, multi-center, and multi-scanner dataset with a huge amount of 846 scans. Not only stroke lesion models can benefit from transfer learning using brain tumor data, but combining the MR modalities using different training schemes also highly improves segmentation performance. The method achieved a top-1 ranking in the ongoing ISLES'22 challenge and performed particularly well on lesion-wise metrics of interest to neuroradiologists, achieving a Dice coefficient of 78.69% and a lesion-wise F1 score of 82.46%. Also, the method was relatively robust on the AMC I (Dice, 60.35%; lesion-wise F1, 68.30%) and II (Dice; 74.12%; lesion-wise F1, 67.53%) datasets in different settings. The high segmentation accuracy of our proposed method could improve radiologists' ability to detect ischemic stroke lesions in MRI images. Our model weights and inference code are available on https://github.com/MDOpx/ISLES22-model-inference .

Analysis of multimodal fusion strategies in deep learning for ischemic stroke lesion segmentation on computed tomography perfusion data

Analysis of multimodal fusion strategies in deep learning for ischemic stroke lesion segmentation on computed tomography perfusion data

Spatio-temporal physics-informed learning: A novel approach to CT perfusion analysis in acute ischemic stroke.

CT perfusion imaging is important in the imaging workup of acute ischemic stroke for evaluating affected cerebral tissue. CT perfusion analysis software produces cerebral perfusion maps from commonly noisy spatio-temporal CT perfusion data. High levels of noise can influence the results of CT perfusion analysis, necessitating software tuning. This work proposes a novel approach for CT perfusion analysis that uses physics-informed learning, an optimization framework that is robust to noise. In particular, we propose SPPINN: Spatio-temporal Perfusion Physics-Informed Neural Network and research spatio-temporal physics-informed learning. SPPINN learns implicit neural representations of contrast attenuation in CT perfusion scans using the spatio-temporal coordinates of the data and employs these representations to estimate a continuous representation of the cerebral perfusion parameters. We validate the approach on simulated data to quantify perfusion parameter estimation performance. Furthermore, we apply the method to in-house patient data and the public Ischemic Stroke Lesion Segmentation 2018 benchmark data to assess the correspondence between the perfusion maps and reference standard infarct core segmentations. Our method achieves accurate perfusion parameter estimates even with high noise levels and differentiates healthy tissue from infarcted tissue. Moreover, SPPINN perfusion maps accurately correspond with reference standard infarct core segmentations. Hence, we show that using spatio-temporal physics-informed learning for cerebral perfusion estimation is accurate, even in noisy CT perfusion data. The code for this work is available at https://github.com/lucasdevries/SPPINN.

Hybrid UNet transformer architecture for ischemic stoke segmentation with MRI and CT datasets.

A hybrid UNet and Transformer (HUT) network is introduced to combine the merits of the UNet and Transformer architectures, improving brain lesion segmentation from MRI and CT scans. The HUT overcomes the limitations of conventional approaches by utilizing two parallel stages: one based on UNet and the other on Transformers. The Transformer-based stage captures global dependencies and long-range correlations. It uses intermediate feature vectors from the UNet decoder and improves segmentation accuracy by enhancing the attention and relationship modeling between voxel patches derived from the 3D brain volumes. In addition, HUT incorporates self-supervised learning on the transformer network. This allows the transformer network to learn by maintaining consistency between the classification layers of the different resolutions of patches and augmentations. There is an improvement in the rate of convergence of the training and the overall capability of segmentation. Experimental results on benchmark datasets, including ATLAS and ISLES2018, demonstrate HUT's advantage over the state-of-the-art methods. HUT achieves higher Dice scores and reduced Hausdorff Distance scores in single-modality and multi-modality lesion segmentation. HUT outperforms the state-the-art network SPiN in the single-modality MRI segmentation on Anatomical Tracings of lesion After Stroke (ATLAS) dataset by 4.84% of Dice score and a large margin of 40.7% in the Hausdorff Distance score. HUT also performed well on CT perfusion brain scans in the Ischemic Stroke Lesion Segmentation (ISLES2018) dataset and demonstrated an improvement over the recent state-of-the-art network USSLNet by 3.3% in the Dice score and 12.5% in the Hausdorff Distance score. With the analysis of both single and multi-modalities datasets (ATLASR12 and ISLES2018), we show that HUT can perform and generalize well on different datasets. Code is available at: https://github.com/vicsohntu/HUT_CT.

CNN-Res: deep learning framework for segmentation of acute ischemic stroke lesions on multimodal MRI images

Background Accurate segmentation of stroke lesions on MRI images is very important for neurologists in the planning of post-stroke care. Segmentation helps clinicians to better diagnose and evaluation of any treatment risks. However, manual segmentation of brain lesions relies on the experience of neurologists and is also a very tedious and time-consuming process. So, in this study, we proposed a novel deep convolutional neural network (CNN-Res) that automatically performs the segmentation of ischemic stroke lesions from multimodal MRIs.MethodsCNN-Res used a U-shaped structure, so the network has encryption and decryption paths. The residual units are embedded in the encoder path. In this model, to reduce gradient descent, the residual units were used, and to extract more complex information in images, multimodal MRI data were applied. In the link between the encryption and decryption subnets, the bottleneck strategy was used, which reduced the number of parameters and training time compared to similar research.ResultsCNN-Res was evaluated on two distinct datasets. First, it was examined on a dataset collected from the Neuroscience Center of Tabriz University of Medical Sciences, where the average Dice coefficient was equal to 85.43%. Then, to compare the efficiency and performance of the model with other similar works, CNN-Res was evaluated on the popular SPES 2015 competition dataset where the average Dice coefficient was 79.23%.ConclusionThis study presented a new and accurate method for the segmentation of MRI medical images using a deep convolutional neural network called CNN-Res, which directly predicts segment maps from raw input pixels.

An exploration enhanced dynamic arithmetic optimization based modified fuzzy clustering framework for ischemic stroke lesion segmentation

An exploration enhanced dynamic arithmetic optimization based modified fuzzy clustering framework for ischemic stroke lesion segmentation

Deep learning-based automated lesion segmentation on mouse stroke magnetic resonance images

Magnetic resonance imaging (MRI) is widely used for ischemic stroke lesion detection in mice. A challenge is that lesion segmentation often relies on manual tracing by trained experts, which is labor-intensive, time-consuming, and prone to inter- and intra-rater variability. Here, we present a fully automated ischemic stroke lesion segmentation method for mouse T2-weighted MRI data. As an end-to-end deep learning approach, the automated lesion segmentation requires very little preprocessing and works directly on the raw MRI scans. We randomly split a large dataset of 382 MRI scans into a subset (n = 293) to train the automated lesion segmentation and a subset (n = 89) to evaluate its performance. We compared Dice coefficients and accuracy of lesion volume against manual segmentation, as well as its performance on an independent dataset from an open repository with different imaging characteristics. The automated lesion segmentation produced segmentation masks with a smooth, compact, and realistic appearance that are in high agreement with manual segmentation. We report dice scores higher than the agreement between two human raters reported in previous studies, highlighting the ability to remove individual human bias and standardize the process across research studies and centers.

W-Net: A boundary-enhanced segmentation network for stroke lesions

Accurate lesion segmentation is a critical technology basis for the treatment and prognosis of stroke. Stroke lesion segmentation suffers from complex background and noise interferes due to the similar grayscale characteristics of tissue structures and imaging mode in medical image. To resolve the difficulty of fuzzy boundary for lesion segmentation, we propose a novel two-stage brain MRI lesion segmentation method, called W-Net. W-Net leverages the CNN and transformer-based method as the backbone network, and introduces boundary deformation module (BDM), boundary constraint module (BCM) to handle the tough condition of fuzzy boundary. The BDM utilizes circular convolution to correct the initial boundary and BCM exploits dilated convolution to dynamically constrain the object boundary. Moreover, we design a multi-task learning loss function to optimize the W-Net from both region and boundary perspectives. Extensive experiments are conducted using the two ischemic stroke lesion segmentation datasets, and the results are compared with other advanced models. The experimental results demonstrate that the proposed method is effective in preserving the edge information of stroke lesions, thus achieving competitive performance on the segmentation task.

IS-Net: Automatic Ischemic Stroke Lesion Segmentation on CT Images

Ischemic stroke is an acute cerebral vascular disease and makes up about 80% of all stroke cases. Non-contrast computed tomography (NCCT) is a widely applied imaging technique for ischemic stroke assessment. However, it is challenging to identify ischemic lesion on NCCT images due to its high variability in location, contrast, and geometry. In this work, we propose IS-Net, an encoder-decoder convolutional neural network for automatic ischemic stroke lesion segmentation on NCCT images. The proposed IS-Net takes hierarchical network as backbone while pyramid feature aggregation (PFA) module is designed to aggregate features from multi stages of backbone, and reasonable feature fusion strategy is considered in PFA to enhance multi-level propagation. To fully mine the boundary cues, edge constraint scheme is introduced by deep supervision which broadcasts low-level features to different modules. In addition, to overcome the limitation of fixed geometric structure of convolution for multi-range dependency exploitation, non-local parallel decoder is introduced with deformable convolution and self-attention. The proposed IS-Net is evaluated on manually labeled follow-up NCCT dataset composed of 1,004 cases (totally 9,020 images). The proposed IS-Net is compared with the state-of-the-art segmentation models and illustrates the highest score on segmentation criteria and sensitivity.

PerfU-Net: Baseline infarct estimation from CT perfusion source data for acute ischemic stroke.

CT perfusion imaging is commonly used for infarct core quantification in acute ischemic stroke patients. The outcomes and perfusion maps of CT perfusion software, however, show many discrepancies between vendors. We aim to perform infarct core segmentation directly from CT perfusion source data using machine learning, excluding the need to use the perfusion maps from standard CT perfusion software. To this end, we present a symmetry-aware spatio-temporal segmentation model that encodes the micro-perfusion dynamics in the brain, while decoding a static segmentation map for infarct core assessment. Our proposed spatio-temporal PerfU-Net employs an attention module on the skip-connections to match the dimensions of the encoder and decoder. We train and evaluate the method on 94 and 62 scans, respectively, using the Ischemic Stroke Lesion Segmentation (ISLES) 2018 challenge data. We achieve state-of-the-art results compared to methods that only use CT perfusion source imaging with a Dice score of 0.46. We are almost on par with methods that use perfusion maps from third party software, whilst it is known that there is a large variation in these perfusion maps from various vendors. Moreover, we achieve improved performance compared to simple perfusion map analysis, which is used in clinical practice.

TSRL-Net: Target-aware supervision residual learning for stroke segmentation

Accurate stroke segmentation is a crucial task in establishing a computer-aided diagnostic system for brain diseases. However, reducing false negatives and accurately segmenting strokes in MRI images is often challenging because of the class imbalance and intraclass ambiguities problems. To address these issues, we propose a novel target-aware supervision residual learning framework for stroke segmentation. Considering the problem of imbalance of positive and negative samples, a creatively target-aware loss function is designed to dilate strong attention regions, pay high attention to the positive sample losses, and compensate for the loss of negative samples around the target. Then, a coarse-grained residual learning module is developed to gradually fix the lost residual features during the decoding phase to alleviate the problem of high number of false negatives caused by intraclass ambiguities. Here, our reverse/positive attention unit suppresses redundant target/background noise and allows relatively more focused highlighting of important features in the target residual region. Extensive experiments were performed on the Anatomical Tracings of Lesions After Stroke and Ischemic Stroke Lesion Segmentation public datasets, with results suggesting the effectiveness of our proposed method compared to several state-of-the-art methods.

Tumor Diagnosis against Other Brain Diseases Using T2 MRI Brain Images and CNN Binary Classifier and DWT.

Brain tumors are diagnosed and classified manually and noninvasively by radiologists using Magnetic Resonance Imaging (MRI) data. The risk of misdiagnosis may exist due to human factors such as lack of time, fatigue, and relatively low experience. Deep learning methods have become increasingly important in MRI classification. To improve diagnostic accuracy, researchers emphasize the need to develop Computer-Aided Diagnosis (CAD) computational diagnostics based on artificial intelligence (AI) systems by using deep learning methods such as convolutional neural networks (CNN) and improving the performance of CNN by combining it with other data analysis tools such as wavelet transform. In this study, a novel diagnostic framework based on CNN and DWT data analysis is developed for the diagnosis of glioma tumors in the brain, among other tumors and other diseases, with T2-SWI MRI scans. It is a binary CNN classifier that treats the disease "glioma tumor" as positive and the other pathologies as negative, resulting in a very unbalanced binary problem. The study includes a comparative analysis of a CNN trained with wavelet transform data of MRIs instead of their pixel intensity values in order to demonstrate the increased performance of the CNN and DWT analysis in diagnosing brain gliomas. The results of the proposed CNN architecture are also compared with a deep CNN pre-trained on VGG16 transfer learning network and with the SVM machine learning method using DWT knowledge. To improve the accuracy of the CNN classifier, the proposed CNN model uses as knowledge the spatial and temporal features extracted by converting the original MRI images to the frequency domain by performing Discrete Wavelet Transformation (DWT), instead of the traditionally used original scans in the form of pixel intensities. Moreover, no pre-processing was applied to the original images. The images used are MRIs of type T2-SWI sequences parallel to the axial plane. Firstly, a compression step is applied for each MRI scan applying DWT up to three levels of decomposition. These data are used to train a 2D CNN in order to classify the scans as showing glioma or not. The proposed CNN model is trained on MRI slices originated from 382 various male and female adult patients, showing healthy and pathological images from a selection of diseases (showing glioma, meningioma, pituitary, necrosis, edema, non-enchasing tumor, hemorrhagic foci, edema, ischemic changes, cystic areas, etc.). The images are provided by the database of the Medical Image Computing and Computer-Assisted Intervention (MICCAI) and the Ischemic Stroke Lesion Segmentation (ISLES) challenges on Brain Tumor Segmentation (BraTS) challenges 2016 and 2017, as well as by the numerous records kept in the public general hospital of Chania, Crete, "Saint George". The proposed frameworks are experimentally evaluated by examining MRI slices originating from 190 different patients (not included in the training set), of which 56% are showing gliomas by the longest two axes less than 2 cm and 44% are showing other pathological effects or healthy cases. Results show convincing performance when using as information the spatial and temporal features extracted by the original scans. With the proposed CNN model and with data in DWT format, we achieved the following statistic percentages: accuracy 0.97, sensitivity (recall) 1, specificity 0.93, precision 0.95, FNR 0, and FPR 0.07. These numbers are higher for this data format (respectively: accuracy by 6% higher, recall by 11%, specificity by 7%, precision by 5%, FNR by 0.1%, and FPR is the same) than it would be, had we used as input data the intensity values of the MRIs (instead of the DWT analysis of the MRIs). Additionally, our study showed that when our CNN takes into account the TL of the existing network VGG, the performance values are lower, as follows: accuracy 0.87, sensitivity (recall) 0.91, specificity 0.84, precision 0.86, FNR of 0.08, and FPR 0.14. The experimental results show the outperformance of the CNN, which is not based on transfer learning, but is using as information the MRI brain scans decomposed into DWT information instead of the pixel intensity of the original scans. The results are promising for the proposed CNN based on DWT knowledge to serve for binary diagnosis of glioma tumors among other tumors and diseases. Moreover, the SVM learning model using DWT data analysis performs with higher accuracy and sensitivity than using pixel values.

Ischemic Stroke Lesion Segmentation Using Mutation Model and Generative Adversarial Network

Ischemic stroke lesion segmentation using different types of images, such as Computed Tomography Perfusion (CTP), is important for medical and Artificial intelligence fields. These images are potential resources to enhance machine learning and deep learning models. However, collecting these types of images is a considerable challenge. Therefore, new augmentation techniques are required to handle the lack of collected images presenting Ischemic strokes. In this paper, the proposed model of mutation model using a distance map is integrated into the generative adversarial network (GAN) to generate a synthetic dataset. The Euclidean distance is used to compute the average distance of each pixel with its neighbor in the right and bottom directions. Then a threshold is used to select the adjacent locations with similar intensities for the mutation process. Furthermore, semi-supervised GAN is enhanced and transformed into supervised GAN, where the segmentation and discriminator are shared the same convolution neural network to reduce the computation process. The mutation and GAN models are trained as an end-to-end model. The results show that the mutation model enhances the dice coefficient of the proposed GAN model by 2.54%. Furthermore, it slightly enhances the recall of the proposed GAN model compared to other GAN models.

The multi-level classification network (MCN) with modified residual U-Net for ischemic stroke lesions segmentation from ATLAS

Ischemic and hemorrhagic strokes are two major types of internal brain injury. 3D brain MRI is suggested by neurologists to examine the brain. Manual examination of brain MRI is very sensitive and time-consuming task. However, automatic diagnosis can assist doctors in this regard. Anatomical Tracings of Lesions After Stroke (ATLAS) is publicly available dataset for research experiments. One of the major issues in medical imaging is class imbalance. Similarly, pixel representation of stroke lesion is less than 1% in ATLAS. Second major challenge in this dataset is inter-class similarity. A multi-level classification network (MCN) is proposed for segmentation of ischemic stroke lesions. MCN consists of three cascaded discrete networks. The first network designed to reduce the slice level class imbalance, where a classifier model is trained to extract the slices of stroke lesions from a whole brain MRI volume. The interclass similarity cause to produce false positives in segmented output. Therefore, all extracted stroke slices were divided into overlapping patches (64 × 64) and carried to the second network. The task associated with second network is to classify the patches comprises of stroke lesion. The third network is a 2D modified residual U-Net that segments out the stroke lesions from the patches extracted by the second network. MCN achieved 0.754 mean dice score on test dataset which is higher than the other state-of-the-art methods on the same dataset.

A lightweight asymmetric U-Net framework for acute ischemic stroke lesion segmentation in CT and CTP images

Background and objectives: This paper has introduced a patch-based, residual, asymmetric, encoder-decoder CNN that solves two major problems in acute ischemic stroke lesion segmentation from CT and CT perfusion data using deep neural networks. First, the class imbalance is encountered since the lesion core size covers less than 5% of the volume of the entire brain. Second, deeper neural networks face the drawback of vanishing gradients, and this degrades the learning ability of the network.Methods: The neural network architecture has been designed for better convergence and faster inference time without compromising performance to address these difficulties. It uses a training strategy combining Focal Tversky and Binary cross-entropy loss functions to overcome the class imbalance issue. The model comprises only four resolution steps with a total of 11 convolutional layers. A base filter of 8, used for the residual connection with two convolutional blocks at the encoder side, is doubled after each resolution step. Simultaneously, the decoder consists of residual blocks with one convolutional layer and a constant number of 8 filters in each resolution step. This proposition allows for a lighter build with fewer trainable parameters as well as aids in avoiding overfitting by allowing the decoder to decode only necessary information.Results: The presented method has been evaluated through submission on the publicly accessible platform of the Ischemic Stroke Lesion Segmentation (ISLES) 2018 medical image segmentation challenge achieving the second-highest testing dice similarity coefficient (DSC). The experimental results demonstrate that the proposed model achieves comparable performance to other submitted strategies in terms of DSC Precision, Recall, and Absolute Volume Difference (AVD).Conclusions: Through the proposed approach, the two major research gaps are coherently addressed while achieving high challenge scores by solving the mentioned problems. Our model can serve as a tool for clinicians and radiologists to hasten decision-making and detect strokes efficiently.

Analysis of the Effects of Segmentation Networks and Loss Functions in Ischemic Stroke Lesion Segmentation

Stroke was the cause of one out of every six deaths from cerebrovascular disease in 2020. A stroke occurs in the United States (US) every 40 seconds. Every 3.5 minutes, people die of a stroke. More than total 795,000 stroke cases occur yearly in the US. This study aims to detect the ischemic stroke lesion that occurs in the brain. The Ischemic Stroke Lesion Segmentation (ISLES) 2017 data set, which includes 82 Magnetic Resonance images of 43 patients, was used. The UNet, Attention UNet, Residual UNet, Attention Residual UNet, and Residual UNet++ segmentation networks were tested. Moreover, Cross Entropy, Dice, IoU, Tversky, Focal Tversky, and their compound forms were analyzed. The IoU loss function tested on Attention UNet achieved the best performance with the dice score of 0.766, the IoU score of 0.621, the sensitivity of 0.730, the specificity of 0.997, the precision of 0.805, and the accuracy of 0.993.

Towards an Accurate MRI Acute Ischemic Stroke Lesion Segmentation Based on Bioheat Equation and U-Net Model

Acute ischemic stroke represents a cerebrovascular disease, for which it is practical, albeit challenging to segment and differentiate infarct core from salvageable penumbra brain tissue. Ischemic stroke causes the variation of cerebral blood flow and heat generation due to metabolism. Therefore, the temperature is modified in the ischemic stroke region. In this paper, we incorporate acute ischemic stroke temperature profile to reinforce segmentation accuracy in MRI. Pennes bioheat equation was used to generate brain thermal images that may provide rich information regarding the temperature change in acute ischemic stroke lesions. The thermal images were generated by calculating the temperature of the brain with acute ischemic stroke. Then, U-Net was used in this paper for the segmentation of acute ischemic stroke. A dataset of 3192 images was created to train U-Net using k-fold crossvalidation. The training time was about 10 hours and 35 minutes in NVIDIA GPU. Next, the obtained trained model was compared with recent methods to analyze the effect of the ischemic stroke temperature profile in segmentation. The obtained results show that significant parts of acute ischemic stroke and background areas are segmented only in thermal images, which proves the importance of using thermal information to improve the segmentation outcomes in MRI diagnosis.