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A standardized protocol for manually segmenting stroke lesions on high-resolution T1-weighted MR images.

Bethany P Lo1, Miranda R Donnelly1, Giuseppe Barisano2

  • 1Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States.

Frontiers in Neuroimaging
|August 9, 2023
PubMed
Summary

This study presents a standardized protocol for manual stroke lesion segmentation on MRI scans. The detailed method ensures consistent tracing by multiple individuals, improving reproducibility in stroke research.

Keywords:
ITK-SNAPMRI segmentationT1w MRImanual segmentationsegmentation protocolstrokestroke lesion

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Area of Science:

  • Neurology
  • Medical Imaging

Background:

  • Manual segmentation remains the gold standard for stroke lesion analysis despite advancements in automated methods.
  • Accurate lesion segmentation is crucial for understanding stroke pathophysiology and treatment efficacy.

Purpose of the Study:

  • To describe a detailed, standardized protocol for manual stroke lesion tracing on 3D T1-weighted MRI.
  • To provide a reproducible method for training individuals in consistent lesion segmentation.
  • To enhance the reliability of manual stroke lesion segmentation in research.

Main Methods:

  • Development of a step-by-step protocol for manual lesion tracing on 3D T1-weighted MRI.
  • Training of six individuals ('tracers') using the standardized protocol.
  • Calculation of inter-rater and intra-rater reliability using intraclass correlation and Dice similarity coefficient.

Main Results:

  • High inter-rater reliability (intraclass correlation: 0.98) and intra-rater reliability (intraclass correlation: 0.99).
  • Strong agreement between raters (Dice similarity coefficient: 0.727) and within raters (Dice similarity coefficient: 0.839).
  • Demonstrated consistency in lesion tracing across multiple trained individuals.

Conclusions:

  • The developed protocol provides a standardized guideline for manual stroke lesion segmentation in T1-weighted MRI.
  • The protocol effectively promotes reproducibility and consistency in stroke research.
  • This standardized approach supports reliable manual analysis of stroke lesions.