A Review on Computer Aided Diagnosis of Acute Brain Stroke.

Amongst the most common causes of death globally, stroke is one of top three affecting over 100 million people worldwide annually. There are two classes of stroke, namely ischemic stroke (due to impairment of blood supply, accounting for ~70% of all strokes) and hemorrhagic stroke (due to bleeding), both of which can result, if untreated, in permanently damaged brain tissue. The discovery that the affected brain tissue (i.e., 'ischemic penumbra') can be salvaged from permanent damage and the bourgeoning growth in computer aided diagnosis has led to major advances in stroke management. Abiding to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, we have surveyed a total of 177 research papers published between 2010 and 2021 to highlight the current status and challenges faced by computer aided diagnosis (CAD), machine learning (ML) and deep learning (DL) based techniques for CT and MRI as prime modalities for stroke detection and lesion region segmentation. This work concludes by showcasing the current requirement of this domain, the preferred modality, and prospective research areas

Synchronous Image-Label Diffusion Probability Model with Application to Stroke Lesion Segmentation on Non-contrast CT

Stroke lesion volume is a key radiologic measurement for assessing the prognosis of Acute Ischemic Stroke (AIS) patients, which is challenging to be automatically measured on Non-Contrast CT (NCCT) scans. Recent diffusion probabilistic models have shown potentials of being used for image segmentation. In this paper, a novel Synchronous image-label Diffusion Probability Model (SDPM) is proposed for stroke lesion segmentation on NCCT using Markov diffusion process. The proposed SDPM is fully based on a Latent Variable Model (LVM), offering a complete probabilistic elaboration. An additional net-stream, parallel with a noise prediction stream, is introduced to obtain initial noisy label estimates for efficiently inferring the final labels. By optimizing the specified variational boundaries, the trained model can infer multiple label estimates for reference given the input images with noises. The proposed model was assessed on three stroke lesion datasets including one public and two private datasets. Compared to several U-net and transformer-based segmentation methods, our proposed SDPM model is able to achieve state-of-the-art performance. The code is publicly available

Stroke Lesion Segmentation and Deep Learning: A Comprehensive Review

Stroke is a medical condition that affects around 15 million people annually. Patients and their families can face severe financial and emotional challenges as it can cause motor, speech, cognitive, and emotional impairments. Stroke lesion segmentation identifies the stroke lesion visually while providing useful anatomical information. Though different computer-aided software areavailable for manual segmentation, state-of-the-art deep learning makes the job much easier. This review paper explores the different deep-learning-based lesion segmentation models and the impact of different pre-processing techniques on their performance. It aims to provide a comprehensive overview of the state-of-the-art models and aims to guide future research and contribute to thedevelopment of more robust and effective stroke lesion segmentation models

Predicting Infarct Core From Computed Tomography Perfusion in Acute Ischemia With Machine Learning: Lessons From the ISLES Challenge.

BACKGROUND AND PURPOSE The ISLES challenge (Ischemic Stroke Lesion Segmentation) enables globally diverse teams to compete to develop advanced tools for stroke lesion analysis with machine learning. Detection of irreversibly damaged tissue on computed tomography perfusion (CTP) is often necessary to determine eligibility for late-time-window thrombectomy. Therefore, the aim of ISLES-2018 was to segment infarcted tissue on CTP based on diffusion-weighted imaging as a reference standard. METHODS The data, from 4 centers, consisted of 103 cases of acute anterior circulation large artery occlusion stroke who underwent diffusion-weighted imaging rapidly after CTP. Diffusion-weighted imaging lesion segmentation was performed manually and acted as a reference standard. The data were separated into 63 cases for training and 40 for testing, upon which quality metrics (dice score coefficient, Hausdorff distance, absolute lesion volume difference, etc) were computed to rank methods based on their overall performance. RESULTS Twenty-four different teams participated in the challenge. Median time to CTP was 185 minutes (interquartile range, 180-238), the time between CTP and magnetic resonance imaging was 36 minutes (interquartile range, 25-79), and the median infarct lesion size was 15.2 mL (interquartile range, 5.7-45). The best performance for Dice score coefficient and absolute volume difference were 0.51 and 10.1 mL, respectively, from different teams. Based on the ranking criteria, the top team's algorithm demonstrated for average Dice score coefficient and average absolute volume difference 0.51 and 10.2 mL, respectively, outperforming the conventional threshold-based method (dice score coefficient, 0.3; volume difference, 15.3). Diverse algorithms were used, almost all based on deep learning, with top-ranked approaches making use of the raw perfusion data as well as methods to synthetically generate complementary information to boost prediction performance. CONCLUSIONS Machine learning methods may predict infarcted tissue from CTP with improved accuracy compared with threshold-based methods used in clinical routine. This dataset will remain public and can be used to test improvement in algorithms over time