Ischemic Stroke Lesion Core Segmentation from CT Perfusion Scans Using Attention ResUnet Deep Learning

Accurate segmentation of ischemic stroke lesions is crucial for refining diagnosis, prognosis, and treatment planning. Manual identification is time-consuming and challenging, especially in urgent clinical scenarios. This paper presents an innovative deep learning–based system for automated segmentation of ischemic stroke lesions from Computed Tomography Perfusion (CTP) datasets. This paper introduces a deep learning–based system designed to segment ischemic stroke lesions from Computed Tomography Perfusion (CTP) datasets. The proposed approach integrates Edge Enhancing Diffusion (EED) filtering as a preprocessing step, acting as a form of hard attention to emphasize affected regions. Besides the Attention ResUnet (AttResUnet) architecture with a modified decoder path, incorporating spatial and channel attention mechanisms to capture long-range dependencies. The system was evaluated using the ISLES challenge 2018 dataset with a fivefold cross-validation approach. The proposed framework achieved a noteworthy average Dice Similarity Coefficient (DSC) score of 59%. This performance underscores the effectiveness of combining EED filtering with attention mechanisms in the AttResUnet architecture for accurate stroke lesion segmentation. The fold-wise analysis revealed consistent performance across different data subsets, with slight variations highlighting the model's generalizability. The proposed approach offers a reliable and generalizable tool for automated ischemic stroke lesion segmentation, potentially improving efficiency and accuracy in clinical settings.