Evaluation of Siemens Healthineers' StrokeSegApp for automated diffusion and perfusion lesion segmentation in patients with ischemic stroke.

Abstract

Purpose: This study aimed to evaluate the perfomance of Siemens Healthineers' StrokeSegApp performance in automatically segmenting diffusion and perfusion lesions in patients with acute ischemic stroke and to assess its clinical utility in guiding mechanical thrombectomy decisions.

Methods: This retrospective study used MRI data of acute ischemic stroke patients from the prospective observational single-center 1000Plus study, acquired between September 2008 and June 2013 (clinicaltrials.org; NCT00715533) and manually segmented by radiologists as the ground truth. The performance of the StrokeSegApp was compared against this ground truth using the dice similarity coefficient (DSC) and Bland-Altman plots. The study also evaluated the application's ability to recommend mechanical thrombectomy based on DEFUSE 2 and 3 trial criteria.

Results: The StrokeSegApp demonstrated a mean DSC of 0.60 (95% CI: 0.57-0.63; n = 241) for diffusion deficit segmentation and 0.80 (95% CI: 0.76-0.85; n = 56) for perfusion deficit segmentation. The mean volume deviation was 0.49 mL for diffusion lesions and -7.69 mL for perfusion lesions. Out of 56 subjects meeting DEFUSE 2/3 criteria in the cohort, it correctly identified mechanical thrombectomy candidates with a sensitivity of 82.1% (95% CI: 63.1-93.9%) and a specificity of 96.4% (95% CI: 81.7-99.9%).

Conclusion: The Siemens Healthineers' StrokeSegApp provides accurate automated segmentation of ischemic stroke lesions, comparable to human experts as well as similar commercial software, and shows potential as a reliable tool in clinical decision-making for stroke treatment.