Ischemic stroke, caused by cerebral vessel occlusion, presents substantial challenges in medical imaging due to the variability and subtlety of stroke lesions. Magnetic Resonance Imaging (MRI) plays a crucial role in diagnosing and managing ischemic stroke, yet existing segmentation techniques often fail to accurately delineate lesions. This study introduces a novel deep learning-based method for segmenting ischemic stroke lesions using multi-channel MRI modalities, including Diffusion Weighted Imaging (DWI), Apparent Diffusion Coefficient (ADC), and enhanced Diffusion Weighted Imaging (eDWI). The proposed architecture integrates DenseNet121 as the encoder with Self-Organized Operational Neural Networks (SelfONN) in the decoder, enhanced by Channel and Space Compound Attention (CSCA) and Double Squeeze-and-Excitation (DSE) blocks. Additionally, a custom loss function combining Dice Loss and Jaccard Loss with weighted averages is introduced to improve model performance. Trained and evaluated on the ISLES 2022 dataset, the model achieved Dice Similarity Coefficients (DSC) of 83.88% using DWI alone, 85.86% with DWI and ADC, and 87.49% with the integration of DWI, ADC, and eDWI. This approach not only outperforms existing methods but also addresses key limitations in current segmentation practices. These advancements significantly enhance diagnostic precision and treatment planning for ischemic stroke, providing valuable support for clinical decision-making.

BACKGROUND AND PURPOSE: Alberta Stroke Program Early CT Score (ASPECTS) was devised as a systematic method to assess the extent of early ischemic change on noncontrast CT (NCCT) in patients with acute ischemic stroke (AIS). Our aim was to automate ASPECTS to objectively score NCCT of AIS patients. MATERIALS AND METHODS: We collected NCCT images with a 5-mm thickness of 257 patients with acute ischemic stroke ( 8 hours from onset to scans) followed by a diffusion-weighted imaging acquisition within 1 hour. Expert ASPECTS readings on DWI were used as ground truth. Texture features were extracted from each ASPECTS region of the 157 training patient images to train a random forest classifier. The unseen 100 testing patient images were used to evaluate the performance of the trained classifier.