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Segmentation of Acute Ischemic Stroke in Native and Enhanced CT using Uncertainty-aware Labels

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Bildverarbeitung für die Medizin 2024 (BVM 2024)

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Abstract

In stroke diagnosis, a non-contrast CT (NCCT) is the first scan acquired and bears the possibility to identify ischemic changes in the brain. Their identification and segmentation are subject to high inter-rater variability. We develop and evaluate models based on labels that reflect the uncertainty in segmentation hypotheses by annotation of minimum (“inner”) and maximum (“outer”) contours of perceived presence of infarct core and hypoperfused tissue. These labels are used for training nnU-Net to segment both from NCCT and CT angiography (CTA) scans of 167 patients. The predicted output is post-processed to obtain delineations of the tissue of interest at varying distances between inner and outer contours. Compared to the ground truth, infarcts of medium size (10 to 70 ml) could be segmented in the NCCT scans with a median error of 3.7 ml (6.2 ml for CTA) of excess predicted volume, missing 6.4 ml (3.5 ml) of the infarct.

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References

  1. Tsao CW, Aday AW, Almarzooq ZI, Anderson CA, Arora P, Avery CL et al. Heart disease and stroke statistics—2023 update: a report from the American Heart Association. Circ. 2023;147(8):e93–e621.

    Google Scholar 

  2. Grotta JC, Chiu D, Lu M, Patel S, Levine SR, Tilley BC et al. Agreement and variability in the interpretation of early CT changes in stroke patients qualifying for intravenous rtPA therapy. Stroke. 1999;30(8):1528–33.

    Google Scholar 

  3. Lin SY, Chiang PL, Chen PW, Cheng LH, Chen MH, Chang PC et al. Toward automated segmentation for acute ischemic stroke using non-contrast computed tomography. Int J Comput Assist Radiol Surg. 2022;17(4):661–71.

    Google Scholar 

  4. Mayer TE, Hamann GF, Baranczyk J, Rosengarten B, Klotz E, Wiesmann M et al. Dynamic CT perfusion imaging of acute stroke. AJNR Am J Neuroradiol. 2000;21(8):1441–9.

    Google Scholar 

  5. Kim Y, Lee S, Abdelkhaleq R, Lopez-Rivera V, Navi B, Kamel H et al. Utilization and availability of advanced imaging in patients with acute ischemic stroke. Circ Cardiovasc Qual Outcomes. 2021;14(4):e006989.

    Google Scholar 

  6. Ostmeier S, Axelrod B, Pulli B, Verhaaren BF, Mahammedi A, Liu Y et al. Random expert sampling for deep learning segmentation of acute ischemic stroke on non-contrast CT. arXiv:2309.03930. 2023.

  7. Isensee F, Jaeger PF, Kohl SA, Petersen J, Maier-Hein KH. nnU-net: self-configuring deep learning-based biomedical image segmentation. Nat Methods. 2021;18(2):203–11.

    Google Scholar 

  8. Joskowicz L, Cohen D, Caplan N, Sosna J. Inter-observer variability of manual contour delineation of structures in CT. Eur Radiol. 2019;29:1391–9.

    Google Scholar 

  9. Strutz T. The distance transform and its computation. arXiv:2106.03503. 2021.

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Correspondence to Linda Vorberg .

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© 2024 Der/die Autor(en), exklusiv lizenziert an Springer Fachmedien Wiesbaden GmbH, ein Teil von Springer Nature

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Vorberg, L., Taubmann, O., Ditt, H., Maier, A. (2024). Segmentation of Acute Ischemic Stroke in Native and Enhanced CT using Uncertainty-aware Labels. In: Maier, A., Deserno, T.M., Handels, H., Maier-Hein, K., Palm, C., Tolxdorff, T. (eds) Bildverarbeitung für die Medizin 2024. BVM 2024. Informatik aktuell. Springer Vieweg, Wiesbaden. https://doi.org/10.1007/978-3-658-44037-4_72

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