A Robust Ensemble Algorithm for Ischemic Stroke Lesion Segmentation: Generalizability and Clinical Utility Beyond the ISLES Challenge

Diffusion-weighted MRI (DWI) is essential for stroke diagnosis, treatment decisions, and prognosis. However, image and disease variability hinder the development of generalizable AI algorithms with clinical value. We address this gap by presenting a novel ensemble algorithm derived from the 2022 Ischemic Stroke Lesion Segmentation (ISLES) challenge. ISLES'22 provided 400 patient scans with ischemic stroke from various medical centers, facilitating the development of a wide range of cutting-edge segmentation algorithms by the research community. Through collaboration with leading teams, we combined top-performing algorithms into an ensemble model that overcomes the limitations of individual solutions. Our ensemble model achieved superior ischemic lesion detection and segmentation accuracy on our internal test set compared to individual algorithms. This accuracy generalized well across diverse image and disease variables. Furthermore, the model excelled in extracting clinical biomarkers. Notably, in a Turing-like test, neuroradiologists consistently preferred the algorithm's segmentations over manual expert efforts, highlighting increased comprehensiveness and precision. Validation using a real-world external dataset (N=1686) confirmed the model's generalizability. The algorithm's outputs also demonstrated strong correlations with clinical scores (admission NIHSS and 90-day mRS) on par with or exceeding expert-derived results, underlining its clinical relevance. This study offers two key findings. First, we present an ensemble algorithm (https://github.com/Tabrisrei/ISLES22_Ensemble) that detects and segments ischemic stroke lesions on DWI across diverse scenarios on par with expert (neuro)radiologists. Second, we show the potential for biomedical challenge outputs to extend beyond the challenge's initial objectives, demonstrating their real-world clinical applicability.

Correlation-Aware Mutual Learning for Semi-supervised Medical Image Segmentation

Semi-supervised learning has become increasingly popular in medical image segmentation due to its ability to leverage large amounts of unlabeled data to extract additional information. However, most existing semi-supervised segmentation methods only focus on extracting information from unlabeled data, disregarding the potential of labeled data to further improve the performance of the model. In this paper, we propose a novel Correlation Aware Mutual Learning (CAML) framework that leverages labeled data to guide the extraction of information from unlabeled data. Our approach is based on a mutual learning strategy that incorporates two modules: the Cross-sample Mutual Attention Module (CMA) and the Omni-Correlation Consistency Module (OCC). The CMA module establishes dense cross-sample correlations among a group of samples, enabling the transfer of label prior knowledge to unlabeled data. The OCC module constructs omni-correlations between the unlabeled and labeled datasets and regularizes dual models by constraining the omni-correlation matrix of each sub-model to be consistent. Experiments on the Atrial Segmentation Challenge dataset demonstrate that our proposed approach outperforms state-of-the-art methods, highlighting the effectiveness of our framework in medical image segmentation tasks. The codes, pre-trained weights, and data are publicly available.

PATCorrect: Non-autoregressive Phoneme-augmented Transformer for ASR Error Correction

Speech-to-text errors made by automatic speech recognition (ASR) system negatively impact downstream models relying on ASR transcriptions. Language error correction models as a post-processing text editing approach have been recently developed for refining the source sentences. However, efficient models for correcting errors in ASR transcriptions that meet the low latency requirements of industrial grade production systems have not been well studied. In this work, we propose a novel non-autoregressive (NAR) error correction approach to improve the transcription quality by reducing word error rate (WER) and achieve robust performance across different upstream ASR systems. Our approach augments the text encoding of the Transformer model with a phoneme encoder that embeds pronunciation information. The representations from phoneme encoder and text encoder are combined via multi-modal fusion before feeding into the length tagging predictor for predicting target sequence lengths. The joint encoders also provide inputs to the attention mechanism in the NAR decoder. We experiment on 3 open-source ASR systems with varying speech-to-text transcription quality and their erroneous transcriptions on 2 public English corpus datasets. Results show that our PATCorrect (Phoneme Augmented Transformer for ASR error Correction) consistently outperforms state-of-the-art NAR error correction method on English corpus across different upstream ASR systems. For example, PATCorrect achieves 11.62% WER reduction (WERR) averaged on 3 ASR systems compared to 9.46% WERR achieved by other method using text only modality and also achieves an inference latency comparable to other NAR models at tens of millisecond scale, especially on GPU hardware, while still being 4.2 - 6.7x times faster than autoregressive models on Common Voice and LibriSpeech datasets.