Stroke segmentation plays a crucial role in the diagnosis and treatment of stroke patients by providing spatial information about affected brain regions and the extent of damage. Segmenting stroke lesions accurately is a challenging task, given that conventional manual techniques are time consuming and prone to errors. Recently, advanced deep models have been introduced for general medical image segmentation, demonstrating promising results that surpass many state of the art networks when evaluated on specific datasets. With the advent of the vision Transformers, several models have been introduced based on them, while others have aimed to design better modules based on traditional convolutional layers to extract long-range dependencies like Transformers. The question of whether such high-level designs are necessary for all segmentation cases to achieve the best results remains unanswered. In this study, we selected four types of deep models that were recently proposed and evaluated their performance for stroke segmentation: a pure Transformer-based architecture (DAE-Former), two advanced CNN-based models (LKA and DLKA) with attention mechanisms in their design, an advanced hybrid model that incorporates CNNs with Transformers (FCT), and the well-known self-adaptive nnUNet framework with its configuration based on given data. We examined their performance on two publicly available datasets, and found that the nnUNet achieved the best results with the simplest design among all. Revealing the robustness issue of Transformers to such variabilities serves as a potential reason for their weaker performance. Furthermore, nnUNet's success underscores the significant impact of preprocessing and postprocessing techniques in enhancing segmentation results, surpassing the focus solely on architectural designs

Researchers discussed how they used a deep-learning algorithm to detect, quantify, and assess the severity of infarcts in the brain on diffusion-weighted MRI (DWI-MRI) exams in acute ischemic stroke patients in a Sunday presentation at the virtual RSNA 2020 meeting. A team of researchers led by presenter Seung Hyun Hwang of Yonsei University in Seoul, South Korea, developed a deep-learning model that can segment and quantify brain infarcts using DWI-MRI and then assess their severity by analyzing apparent diffusion coefficient (ADC) maps of the lesions. In testing, the model achieved high sensitivity and specificity. "The qualitative and quantitative results of our study show feasibility for detecting and quantifying infarcts," Hwang said. Due to its sensitivity for the detection of small and early infarcts, DWI-MRI is commonly used for evaluation of acute ischemic stroke, according to Hwang.

Estimation of patient-specific model parameters is important for personalized modeling, although sparse and noisy clinical data can introduce significant uncertainty in the estimated parameter values. This importance source of uncertainty, if left unquantified, will lead to unknown variability in model outputs that hinder their reliable adoptions. Probabilistic estimation model parameters, however, remains an unresolved challenge because standard Markov Chain Monte Carlo sampling requires repeated model simulations that are computationally infeasible. A common solution is to replace the simulation model with a computationally-efficient surrogate for a faster sampling. However, by sampling from an approximation of the exact posterior probability density function (pdf) of the parameters, the efficiency is gained at the expense of sampling accuracy. In this paper, we address this issue by integrating surrogate modeling into Metropolis Hasting (MH) sampling of the exact posterior pdfs to improve its acceptance rate. It is done by first quickly constructing a Gaussian process (GP) surrogate of the exact posterior pdfs using deterministic optimization. This efficient surrogate is then used to modify commonly-used proposal distributions in MH sampling such that only proposals accepted by the surrogate will be tested by the exact posterior pdf for acceptance/rejection, reducing unnecessary model simulations at unlikely candidates. Synthetic and real-data experiments using the presented method show a significant gain in computational efficiency without compromising the accuracy. In addition, insights into the non-identifiability and heterogeneity of tissue properties can be gained from the obtained posterior distributions.

The estimation of patient-specific tissue properties in the form of model parameters is important for personalized physiological models. However, these tissue properties are spatially varying across the underlying anatomical model, presenting a significance challenge of high-dimensional (HD) optimization at the presence of limited measurement data. A common solution to reduce the dimension of the parameter space is to explicitly partition the anatomical mesh, either into a fixed small number of segments or a multi-scale hierarchy. This anatomy-based reduction of parameter space presents a fundamental bottleneck to parameter estimation, resulting in solutions that are either too low in resolution to reflect tissue heterogeneity, or too high in dimension to be reliably estimated within feasible computation. In this paper, we present a novel concept that embeds a generative variational auto-encoder (VAE) into the objective function of Bayesian optimization, providing an implicit low-dimensional (LD) search space that represents the generative code of the HD spatially-varying tissue properties. In addition, the VAE-encoded knowledge about the generative code is further used to guide the exploration of the search space. The presented method is applied to estimating tissue excitability in a cardiac electrophysiological model. Synthetic and real-data experiments demonstrate its ability to improve the accuracy of parameter estimation with more than 10x gain in efficiency.