XSRD-Net: EXplainable Stroke Relapse Detection

Stroke is the second most frequent cause of death world wide with an annual mortality of around 5.5 million. Recurrence rates of stroke are between 5 and 25% in the first year. As mortality rates for relapses are extraordinarily high (40%) it is of utmost importance to reduce the recurrence rates. We address this issue by detecting patients at risk of stroke recurrence at an early stage in order to enable appropriate therapy planning. To this end we collected 3D intracranial CTA image data and recorded concomitant heart diseases, the age and the gender of stroke patients between 2010 and 2024. We trained single- and multimodal deep learning based neural networks for binary relapse detection (Task 1) and for relapse free survival (RFS) time prediction together with a subsequent classification (Task 2). The separation of relapse from non-relapse patients (Task 1) could be solved with tabular data (AUC on test dataset: 0.84). However, for the main task, the regression (Task 2), our multimodal XSRD-net processed the modalities vision:tabular with 0.68:0.32 according to modality contribution measures. The c-index with respect to relapses for the multimodal model reached 0.68, and the AUC is 0.71 for the test dataset. Final, deeper interpretability analysis results could highlight a link between both heart diseases (tabular) and carotid arteries (vision) for the detection of relapses and the prediction of the RFS time. This is a central outcome that we strive to strengthen with ongoing data collection and model retraining.

Semi-supervised learning and integration of multi-sequence MR-images for carotid vessel wall and plaque segmentation

The analysis of carotid arteries, particularly plaques, in multi-sequence Magnetic Resonance Imaging (MRI) data is crucial for assessing the risk of atherosclerosis and ischemic stroke. In order to evaluate metrics and radiomic features, quantifying the state of atherosclerosis, accurate segmentation is important. However, the complex morphology of plaques and the scarcity of labeled data poses significant challenges. In this work, we address these problems and propose a semi-supervised deep learning-based approach designed to effectively integrate multi-sequence MRI data for the segmentation of carotid artery vessel wall and plaque. The proposed algorithm consists of two networks: a coarse localization model identifies the region of interest guided by some prior knowledge on the position and number of carotid arteries, followed by a fine segmentation model for precise delineation of vessel walls and plaques. To effectively integrate complementary information across different MRI sequences, we investigate different fusion strategies and introduce a multi-level multi-sequence version of U-Net architecture. To address the challenges of limited labeled data and the complexity of carotid artery MRI, we propose a semi-supervised approach that enforces consistency under various input transformations. Our approach is evaluated on 52 patients with arteriosclerosis, each with five MRI sequences. Comprehensive experiments demonstrate the effectiveness of our approach and emphasize the role of fusion point selection in U-Net-based architectures. To validate the accuracy of our results, we also include an expert-based assessment of model performance. Our findings highlight the potential of fusion strategies and semi-supervised learning for improving carotid artery segmentation in data-limited MRI applications.