A Review of MRI Acute Ischemic Stroke Lesion Segmentation

Immediate treatment of a stroke can minimize long-term effects and even help reduce death risk. In the ischemic stroke cases, there are two zones of injury which are ischemic core and ischemic penumbra zone. The ischemic penumbra indicates the part that is located around the infarct core that is at risk of developing a brain infarction. Recently, various segmentation methods of infarct lesion from the MRI input images were developed and these methods gave a high accuracy in the extraction and detection of the infarct core. However, only some limited works have been reported to isolate the penumbra tissues and infarct core separately. The challenges exist in ischemic core identification are traditional approach prone to error, time-consuming and tedious for medical expert which could delay the treatment. In this paper, we study and analyse the segmentation algorithms for brain MRI ischemic of different categories. The focus of the review is mainly on the segmentation algorithms of infarct core with penumbra and infarct core only. We highlight the advantages and limitations alongside the discussion of the capabilities of these segmentation algorithms and its key challenges. The paper also devised a generic structure for automated stroke lesion segmentation. The performance of these algorithms was investigated by comparing different parameters of the surveyed algorithms. In addition, a new structure of the segmentation process for segmentation of penumbra is proposed by considering the challenges remains. The best accuracy for segmentation of infarct core and penumbra tissues is 82.1% whereas 99.1% for segmentation infarct core only. Meanwhile, the shortest average computational time recorded was 3.42 seconds for segmenting 10 slices of MR images. This paper presents an inclusive analysis of the discussed papers based on different categories of the segmentation algorithm. The proposed structure is important to enable a more robust and accurate assessment in clinical practice. This could be an opportunity for the medical and engineering sector to work together in designing a complete end-to-end automatic framework in detecting stroke lesion and penumbra

Medical image analysis methods in MR/CT-imaged acute-subacute ischemic stroke lesion:Segmentation, prediction and insights into dynamic evolution simulation models. A critical appraisal

AbstractOver the last 15years, basic thresholding techniques in combination with standard statistical correlation-based data analysis tools have been widely used to investigate different aspects of evolution of acute or subacute to late stage ischemic stroke in both human and animal data. Yet, a wave of biology-dependent and imaging-dependent issues is still untackled pointing towards the key question: “how does an ischemic stroke evolve?” Paving the way for potential answers to this question, both magnetic resonance (MRI) and CT (computed tomography) images have been used to visualize the lesion extent, either with or without spatial distinction between dead and salvageable tissue. Combining diffusion and perfusion imaging modalities may provide the possibility of predicting further tissue recovery or eventual necrosis. Going beyond these basic thresholding techniques, in this critical appraisal, we explore different semi-automatic or fully automatic 2D/3D medical image analysis methods and mathematical models applied to human, animal (rats/rodents) and/or synthetic ischemic stroke to tackle one of the following three problems: (1) segmentation of infarcted and/or salvageable (also called penumbral) tissue, (2) prediction of final ischemic tissue fate (death or recovery) and (3) dynamic simulation of the lesion core and/or penumbra evolution. To highlight the key features in the reviewed segmentation and prediction methods, we propose a common categorization pattern. We also emphasize some key aspects of the methods such as the imaging modalities required to build and test the presented approach, the number of patients/animals or synthetic samples, the use of external user interaction and the methods of assessment (clinical or imaging-based). Furthermore, we investigate how any key difficulties, posed by the evolution of stroke such as swelling or reperfusion, were detected (or not) by each method. In the absence of any imaging-based macroscopic dynamic model applied to ischemic stroke, we have insights into relevant microscopic dynamic models simulating the evolution of brain ischemia in the hope to further promising and challenging 4D imaging-based dynamic models. By depicting the major pitfalls and the advanced aspects of the different reviewed methods, we present an overall critique of their performances and concluded our discussion by suggesting some recommendations for future research work focusing on one or more of the three addressed problems

Brain lesion segmentation from diffusion weighted MRI based on adaptive thresholding and gray level co-occurrence matrix

This project presents brain lesion segmentation of diffusion-weighted magnetic resonance images (DWI) based on thresholding technique and gray level co-occurrence matrix (GLCM). The lesions are hyperintense lesion from tumour, acute infarction, haemorrhage and abscess, and hypointense lesion from chronic infarction and haemorrhage. Pre-processing is applied to the DWI for intensity normalization, background removal and intensity enhancement. Then, the lesions are segmented by using two different methods which are thresholding technique and GLCM. For the thresholding technique, image histogram is calculated at each region to find the maximum number of pixels for each intensity level. The optimal threshold is determined by comparing normal and lesion regions. Conversely, GLCM is computed to segment the lesions. Different peaks from the GLCM crosssection indicate the present of normal brain region, cerebral spinal fluid (CSF), hyperintense or hypointense lesions. Minimum and maximum threshold values are computed from the GLCM cross-section. Region and boundary information from the GLCM are introduced as the statistical features for segmentation of hyperintense and hypointense lesions. The proposed technique has been validated by using area overlap (AO), false positive rate (FPR), false negative rate (FNR), misclassified area (MA), mean absolute percentage error (MAPE) and pixels absolute error ratio (rerr). The results are demonstrated in three indexes MA, MAPE and rerr, where 0.3167, 0.1440 and 0.0205 for GLCM, while 0.3211, 0.1524 and 0.0377 for thresholding technique. Overall, GLCM provides better segmentation performance compared to thresholding technique

Brain Lesion Segmentation And Classification Using Diffusion-Weighted Imaging (DWI)

Research and development of brain detection and diagnosis system for brain disorder based on Magnetic Resonance Imaging (MRI) have become one of the most common interest in the past few years. Out of various MRI techniques, Diffusion-Weighted Imaging (DWI) remains the most accurate technique for early detection and discrimination of several brain lesions such as stroke. This study proposed the image analysis technique for automatically segmenting and classifying abnormal lesion structures from DWI. Four lesions namely acute stroke, chronic stroke, solid tumor and necrosis were analyzed. The proposed analysis framework were pre-processing, segmentation, features extraction and classification. Four different segmentation techniques were proposed based on Thresholding with Morphological Operation (TMO), Fuzzy C-Means (FCM), Fuzzy C-Means with Active Contour (FCMAC) and Fuzzy C-Means with Correlation Template (FCMCT) to segment the lesion’s region. Next, the statistical parameters from spatial and wavelet transforms were extracted from the Region of Interest (ROI) as features. These features were classified using a rule-based classifier for automatic classification. The results indicate that FCMCT offered the best performance for Jaccard Index, Dice Index, False Positive Rate and False Negative Rate which were 0.6, 0.73, 0.19 and 0.2 respectively. The overall accuracy, sensitivity and specificity for the classification were 89 %, 86 % and 96 %. In conclusion, the proposed hybrid analysis has the potential to be explored as a computer-aided tool to detect and diagnose of human brain lesion

Automated Region Growing for Segmentation of Brain Lesion in Diffusion-weighted MRI

This paper presents an automatic segmentation of brain lesions from diffusion-weighted magnetic resonance imaging (DW-MRI or DWI) using region growing approach. The lesions are acute infarction, haemorrhage, tumour and abscess. Region splitting and merging is used to detect the lesion region. Then, histogram thresholding technique is applied to automate the seeds selection. The region is iteratively grown by comparing all unallocated neighbour pixels to the seeds. The difference between pixel’s intensity value and the region’s mean is used as the similarity measure. Evaluation is made for performance comparison between automatic and manual seeds selection. Overall, automated region growing algorithm provides comparable results with the semi-automatic segmentation

Rationale, design and methodology of the image analysis protocol for studies of patients with cerebral small vessel disease and mild stroke

Rationale: Cerebral small vessel disease (SVD) is common in ageing and patients with dementia and stroke. Its manifestations on magnetic resonance imaging (MRI) include white matter hyperintensities, lacunes, microbleeds, perivascular spaces, small subcortical infarcts, and brain atrophy. Many studies focus only on one of these manifestations. A protocol for the differential assessment of all these features is, therefore, needed. Aims: To identify ways of quantifying imaging markers in research of patients with SVD and operationalize the recommendations from the STandards for ReportIng Vascular changes on nEuroimaging guidelines. Here, we report the rationale, design, and methodology of a brain image analysis protocol based on our experience from observational longitudinal studies of patients with nondisabling stroke. Design: The MRI analysis protocol is designed to provide quantitative and qualitative measures of disease evolution including: acute and old stroke lesions, lacunes, tissue loss due to stroke, perivascular spaces, microbleeds, macrohemorrhages, iron deposition in basal ganglia, substantia nigra and brain stem, brain atrophy, and white matter hyperintensities, with the latter separated into intense and less intense. Quantitative measures of tissue integrity such as diffusion fractional anisotropy, mean diffusivity, and the longitudinal relaxation time are assessed in regions of interest manually placed in anatomically and functionally relevant locations, and in others derived from feature extraction pipelines and tissue segmentation methods. Morphological changes that relate to cognitive deficits after stroke, analyzed through shape models of subcortical structures, complete the multiparametric image analysis protocol. Outcomes: Final outcomes include guidance for identifying ways to minimize bias and confounds in the assessment of SVD and stroke imaging biomarkers. It is intended that this information will inform the design of studies to examine the underlying pathophysiology of SVD and stroke, and to provide reliable, quantitative outcomes in trials of new therapies and preventative strategies

ISLES 2015 - A public evaluation benchmark for ischemic stroke lesion segmentation from multispectral MRI

Ischemic stroke is the most common cerebrovascular disease, and its diagnosis, treatment, and study relies on non-invasive imaging. Algorithms for stroke lesion segmentation from magnetic resonance imaging (MRI) volumes are intensely researched, but the reported results are largely incomparable due to different datasets and evaluation schemes. We approached this urgent problem of comparability with the Ischemic Stroke Lesion Segmentation (ISLES) challenge organized in conjunction with the MICCAI 2015 conference. In this paper we propose a common evaluation framework, describe the publicly available datasets, and present the results of the two sub-challenges: Sub-Acute Stroke Lesion Segmentation (SISS) and Stroke Perfusion Estimation (SPES). A total of 16 research groups participated with a wide range of state-of-the-art automatic segmentation algorithms. A thorough analysis of the obtained data enables a critical evaluation of the current state-of-the-art, recommendations for further developments, and the identification of remaining challenges. The segmentation of acute perfusion lesions addressed in SPES was found to be feasible. However, algorithms applied to sub-acute lesion segmentation in SISS still lack accuracy. Overall, no algorithmic characteristic of any method was found to perform superior to the others. Instead, the characteristics of stroke lesion appearances, their evolution, and the observed challenges should be studied in detail. The annotated ISLES image datasets continue to be publicly available through an online evaluation system to serve as an ongoing benchmarking resource (www.isles-challenge.org).Peer reviewe

Computerized Analysis of Magnetic Resonance Images to Study Cerebral Anatomy in Developing Neonates

The study of cerebral anatomy in developing neonates is of great importance for the understanding of brain development during the early period of life. This dissertation therefore focuses on three challenges in the modelling of cerebral anatomy in neonates during brain development. The methods that have been developed all use Magnetic Resonance Images (MRI) as source data. To facilitate study of vascular development in the neonatal period, a set of image analysis algorithms are developed to automatically extract and model cerebral vessel trees. The whole process consists of cerebral vessel tracking from automatically placed seed points, vessel tree generation, and vasculature registration and matching. These algorithms have been tested on clinical Time-of- Flight (TOF) MR angiographic datasets. To facilitate study of the neonatal cortex a complete cerebral cortex segmentation and reconstruction pipeline has been developed. Segmentation of the neonatal cortex is not effectively done by existing algorithms designed for the adult brain because the contrast between grey and white matter is reversed. This causes pixels containing tissue mixtures to be incorrectly labelled by conventional methods. The neonatal cortical segmentation method that has been developed is based on a novel expectation-maximization (EM) method with explicit correction for mislabelled partial volume voxels. Based on the resulting cortical segmentation, an implicit surface evolution technique is adopted for the reconstruction of the cortex in neonates. The performance of the method is investigated by performing a detailed landmark study. To facilitate study of cortical development, a cortical surface registration algorithm for aligning the cortical surface is developed. The method first inflates extracted cortical surfaces and then performs a non-rigid surface registration using free-form deformations (FFDs) to remove residual alignment. Validation experiments using data labelled by an expert observer demonstrate that the method can capture local changes and follow the growth of specific sulcus