DeepISLES: a clinically validated ischemic stroke segmentation model from the ISLES'22 challenge

DeepISLES: a clinically validated ischemic stroke segmentation model from the ISLES'22 challenge

Abstract Diffusion-weighted MRI is critical for diagnosing and managing ischemic stroke, but variability in images and disease presentation limits the generalizability of AI algorithms. We present DeepISLES, a robust ensemble algorithm developed from top submissions to the 2022 Ischemic Stroke Lesio...

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Main Authors: Ezequiel de la Rosa, Mauricio Reyes, Sook-Lei Liew, Alexandre Hutton, Roland Wiest, Johannes Kaesmacher, Uta Hanning, Arsany Hakim, Richard Zubal, Waldo Valenzuela, David Robben, Diana M. Sima, Vincenzo Anania, Arne Brys, James A. Meakin, Anne Mickan, Gabriel Broocks, Christian Heitkamp, Shengbo Gao, Kongming Liang, Ziji Zhang, Md Mahfuzur Rahman Siddiquee, Andriy Myronenko, Pooya Ashtari, Sabine Van Huffel, Hyunsu Jeong, Chiho Yoon, Chulhong Kim, Jiayu Huo, Sebastien Ourselin, Rachel Sparks, Albert Clèrigues, Arnau Oliver, Xavier Lladó, Liam Chalcroft, Ioannis Pappas, Jeroen Bertels, Ewout Heylen, Juliette Moreau, Nima Hatami, Carole Frindel, Abdul Qayyum, Moona Mazher, Domenec Puig, Shao-Chieh Lin, Chun-Jung Juan, Tianxi Hu, Lyndon Boone, Maged Goubran, Yi-Jui Liu, Susanne Wegener, Florian Kofler, Ivan Ezhov, Suprosanna Shit, Moritz R. Hernandez Petzsche, Michael Müller, Bjoern Menze, Jan S. Kirschke, Benedikt Wiestler
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-62373-x
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Summary:Abstract Diffusion-weighted MRI is critical for diagnosing and managing ischemic stroke, but variability in images and disease presentation limits the generalizability of AI algorithms. We present DeepISLES, a robust ensemble algorithm developed from top submissions to the 2022 Ischemic Stroke Lesion Segmentation challenge we organized. By combining the strengths of best-performing methods from leading research groups, DeepISLES achieves superior accuracy in detecting and segmenting ischemic lesions, generalizing well across diverse axes. Validation on a large external dataset (N = 1685) confirms its robustness, outperforming previous state-of-the-art models by 7.4% in Dice score and 12.6% in F1 score. It also excels at extracting clinical biomarkers and correlates strongly with clinical stroke scores, closely matching expert performance. Neuroradiologists prefer DeepISLES’ segmentations over manual annotations in a Turing-like test. Our work demonstrates DeepISLES’ clinical relevance and highlights the value of biomedical challenges in developing real-world, generalizable AI tools. DeepISLES is freely available at https://github.com/ezequieldlrosa/DeepIsles .
ISSN:2041-1723

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