Clinically-Informed Preprocessing Improves Stroke Segmentation in Low-Resource Settings

Fuente: arXiv
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Auteurs principaux: Rivera, Juampablo E. Heras, Oswal, Hitender, Ren, Tianyi, Pan, Yutong, Henry, William, Neher, Caitlin M., Kurt, Mehmet
Format: Preprint
Publié: 2025
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author Rivera, Juampablo E. Heras
Oswal, Hitender
Ren, Tianyi
Pan, Yutong
Henry, William
Neher, Caitlin M.
Kurt, Mehmet
author_facet Rivera, Juampablo E. Heras
Oswal, Hitender
Ren, Tianyi
Pan, Yutong
Henry, William
Neher, Caitlin M.
Kurt, Mehmet
contents Stroke is among the top three causes of death worldwide, and accurate identification of ischemic stroke lesion boundaries from imaging is critical for diagnosis and treatment. The main imaging modalities used include magnetic resonance imaging (MRI), particularly diffusion weighted imaging (DWI), and computed tomography (CT)-based techniques such as non-contrast CT (NCCT), contrast-enhanced CT angiography (CTA), and CT perfusion (CTP). DWI is the gold standard for the identification of lesions but has limited applicability in low-resource settings due to prohibitive costs. CT-based imaging is currently the most practical imaging method in low-resource settings due to low costs and simplified logistics, but lacks the high specificity of MRI-based methods in monitoring ischemic insults. Supervised deep learning methods are the leading solution for automated ischemic stroke lesion segmentation and provide an opportunity to improve diagnostic quality in low-resource settings by incorporating insights from DWI when segmenting from CT. Here, we develop a series of models which use CT images taken upon arrival as inputs to predict follow-up lesion volumes annotated from DWI taken 2-9 days later. Furthermore, we implement clinically motivated preprocessing steps and show that the proposed pipeline results in a 38% improvement in Dice score over 10 folds compared to a nnU-Net model trained with the baseline preprocessing. Finally, we demonstrate that through additional preprocessing of CTA maps to extract vessel segmentations, we further improve our best model by 21% over 5 folds.
format Preprint
id arxiv_https___arxiv_org_abs_2508_16004
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Clinically-Informed Preprocessing Improves Stroke Segmentation in Low-Resource Settings
Rivera, Juampablo E. Heras
Oswal, Hitender
Ren, Tianyi
Pan, Yutong
Henry, William
Neher, Caitlin M.
Kurt, Mehmet
Image and Video Processing
Computer Vision and Pattern Recognition
Stroke is among the top three causes of death worldwide, and accurate identification of ischemic stroke lesion boundaries from imaging is critical for diagnosis and treatment. The main imaging modalities used include magnetic resonance imaging (MRI), particularly diffusion weighted imaging (DWI), and computed tomography (CT)-based techniques such as non-contrast CT (NCCT), contrast-enhanced CT angiography (CTA), and CT perfusion (CTP). DWI is the gold standard for the identification of lesions but has limited applicability in low-resource settings due to prohibitive costs. CT-based imaging is currently the most practical imaging method in low-resource settings due to low costs and simplified logistics, but lacks the high specificity of MRI-based methods in monitoring ischemic insults. Supervised deep learning methods are the leading solution for automated ischemic stroke lesion segmentation and provide an opportunity to improve diagnostic quality in low-resource settings by incorporating insights from DWI when segmenting from CT. Here, we develop a series of models which use CT images taken upon arrival as inputs to predict follow-up lesion volumes annotated from DWI taken 2-9 days later. Furthermore, we implement clinically motivated preprocessing steps and show that the proposed pipeline results in a 38% improvement in Dice score over 10 folds compared to a nnU-Net model trained with the baseline preprocessing. Finally, we demonstrate that through additional preprocessing of CTA maps to extract vessel segmentations, we further improve our best model by 21% over 5 folds.
title Clinically-Informed Preprocessing Improves Stroke Segmentation in Low-Resource Settings
topic Image and Video Processing
Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2508.16004