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  4. Concurrent ischemic lesion age estimation and segmentation of CT brain using a transformer-based network
 
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Concurrent ischemic lesion age estimation and segmentation of CT brain using a transformer-based network
File(s)
paper.pdf (3.68 MB)
Accepted version
Author(s)
Marcus, Adam
Bentley, Paul
Rueckert, Daniel
Type
Journal Article
Abstract
The cornerstone of stroke care is expedient management that varies depending on the time since stroke onset. Consequently, clinical decision making is centered on accurate knowledge of timing and often requires a radiologist to interpret Computed Tomography (CT) of the brain to confirm the occurrence and age of an event. These tasks are particularly challenging due to the subtle expression of acute ischemic lesions and the dynamic nature of their appearance. Automation efforts have not yet applied deep learning to estimate lesion age and treated these two tasks independently, so, have overlooked their inherent complementary relationship. To leverage this, we propose a novel end-to-end multi-task transformer-based network optimized for concurrent segmentation and age estimation of cerebral ischemic lesions. By utilizing gated positional self-attention and CT-specific data augmentation, the proposed method can capture long-range spatial dependencies while maintaining its ability to be trained from scratch under low-data regimes commonly found in medical imaging. Furthermore, to better combine multiple predictions, we incorporate uncertainty by utilizing quantile loss to facilitate estimating a probability density function of lesion age. The effectiveness of our model is then extensively evaluated on a clinical dataset consisting of 776 CT images from two medical centers. Experimental results demonstrate that our method obtains promising performance, with an area under the curve (AUC) of 0.933 for classifying lesion ages ≤4.5 hours compared to 0.858 using a conventional approach, and outperforms task-specific state-of-the-art algorithms.
Date Issued
2023-12-01
Date Acceptance
2023-06-13
Citation
IEEE Transactions on Medical Imaging, 2023, 42 (12), pp.3463-3473
URI
http://hdl.handle.net/10044/1/105041
URL
https://ieeexplore.ieee.org/document/10155239
DOI
https://www.dx.doi.org/10.1109/TMI.2023.3287361
ISSN
0278-0062
Publisher
Institute of Electrical and Electronics Engineers
Start Page
3463
End Page
3473
Journal / Book Title
IEEE Transactions on Medical Imaging
Volume
42
Issue
12
Copyright Statement
Copyright © 2023 The Author(s). This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
License URL
https://creativecommons.org/licenses/by/4.0/
Identifier
https://ieeexplore.ieee.org/document/10155239
Publication Status
Published
Date Publish Online
2023-06-19
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