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This study demonstrates that pseudolabelling is the most effective strategy for training robust deep learning models to segment white matter hyperintensities and stroke lesions using partially labelled MRI data. By successfully aggregating private and public datasets, the research provides a viable pathway to overcome annotation scarcity in cerebral small vessel disease monitoring. The findings offer a practical solution for developing high-throughput automated segmentation tools essential for large-scale clinical research.
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Comparative evaluation of training strategies using partially labelled datasets for segmentation of white matter hyperintensities and stroke lesions in FLAIR MRI

arXiv3 min read

arXiv:2601.20503v2 Announce Type: replace-cross Abstract: White matter hyperintensities (WMH) and ischaemic stroke lesions (ISL) are key imaging biomarkers of cerebral small vessel disease (SVD) detectable on magnetic resonance imaging (MRI). The development of robust deep learning models to automatically segment and differentiate these pathologies remains challenging. Specifically, WMH and ISL frequently co-occur within the same subject and present as visually confounding hyperintensities on fluid-attenuated inversion recovery (FLAIR) sequences, complicating their accurate delineation. To address the scarcity of fully annotated cohorts, we systematically evaluated six accessible strategies for training a joint WMH and ISL segmentation model using partially labelled data. We aggregated privately held and publicly available datasets to curate a large-scale cohort of 2,052 MRI volumes, of which 1341 and 1152 volumes contained ground truth annotations for WMH and ISL, respectively. Our analysis indicates that multiple strategies effectively leverage partially labelled data to enhance overall model performance, with pseudolabelling emerging as the most effective approach. This model exhibited a consistent WMH segmentation policy and successfully detected the majority of FLAIR-positive ISL. These findings demonstrate the viability of using partially labelled data to develop reliable automated segmentation tools, which can support ongoing SVD monitoring and high-throughput biomarker extraction for large-scale clinical research.

Abstract:White matter hyperintensities (WMH) and ischaemic stroke lesions (ISL) are key imaging biomarkers of cerebral small vessel disease (SVD) detectable on magnetic resonance imaging (MRI). The development of robust deep learning models to automatically segment and differentiate these pathologies remains challenging. Specifically, WMH and ISL frequently co-occur within the same subject and present as visually confounding hyperintensities on fluid-attenuated inversion recovery (FLAIR) sequences, complicating their accurate delineation. To address the scarcity of fully annotated cohorts, we systematically evaluated six accessible strategies for training a joint WMH and ISL segmentation model using partially labelled data. We aggregated privately held and publicly available datasets to curate a large-scale cohort of 2,052 MRI volumes, of which 1341 and 1152 volumes contained ground truth annotations for WMH and ISL, respectively. Our analysis indicates that multiple strategies effectively leverage partially labelled data to enhance overall model performance, with pseudolabelling emerging as the most effective approach. This model exhibited a consistent WMH segmentation policy and successfully detected the majority of FLAIR-positive ISL. These findings demonstrate the viability of using partially labelled data to develop reliable automated segmentation tools, which can support ongoing SVD monitoring and high-throughput biomarker extraction for large-scale clinical research.

Computer Vision and Pattern Recognition (cs.CV); Artificial Intelligence (cs.AI)

arXiv:2601.20503 [cs.CV]

(or arXiv:2601.20503v2 [cs.CV] for this version)

https://doi.org/10.48550/arXiv.2601.20503 Focus to learn more arXiv-issued DOI via DataCite

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Full text under the publisher's open licence · 294 words

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