# Stroke Lesion Segmentation using Multi-Stage Cross-Scale Attention

arXiv: https://arxiv.org/abs/2501.15423 · HTML: https://mlsanity.com/paper/2501.15423/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 11 of its 14 references that are in the map.
- First posted on arXiv 26 Jan 2025.

## Builds on (most cited first, 11 of 11)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [PyTorch: An Imperative Style, High-Performance Deep Learning Library](https://mlsanity.com/paper/1912.01703/) (2019)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [Multi-Scale High-Resolution Vision Transformer for Semantic Segmentation](https://mlsanity.com/paper/2111.01236/) (2021)
- [MAPPING: Model Average with Post-processing for Stroke Lesion Segmentation](https://mlsanity.com/paper/2211.15486/) (2022)
- [ICPR 2024 Competition on Multiple Sclerosis Lesion Segmentation -- Methods and Results](https://mlsanity.com/paper/2410.07924/) (2024)
- [Vision Backbone Enhancement via Multi-Stage Cross-Scale Attention](https://mlsanity.com/paper/2308.05872/) (2023)
- [Segmenting Small Stroke Lesions with Novel Labeling Strategies](https://mlsanity.com/paper/2408.02929/) (2024)

## Abstract (arXiv)

Precise characterization of stroke lesions from MRI data has immense value in prognosticating clinical and cognitive outcomes following a stroke. Manual stroke lesion segmentation is time-consuming and requires the expertise of neurologists and neuroradiologists. Often, lesions are grossly characterized for their location and overall extent using bounding boxes without specific delineation of their boundaries. While such characterization provides some clinical value, to develop a precise mechanistic understanding of the impact of lesions on post-stroke vascular contributions to cognitive impairments and dementia (VCID), the stroke lesions need to be fully segmented with accurate boundaries. This work introduces the Multi-Stage Cross-Scale Attention (MSCSA) mechanism, applied to the U-Net family, to improve the mapping between brain structural features and lesions of varying sizes. Using the Anatomical Tracings of Lesions After Stroke (ATLAS) v2.0 dataset, MSCSA outperforms all baseline methods in both Dice and F1 scores on a subset focusing on small lesions, while maintaining competitive performance across the entire dataset. Notably, the ensemble strategy incorporating MSCSA achieves the highest scores for Dice and F1 on both the full dataset and the small lesion subset. These results demonstrate the effectiveness of MSCSA in segmenting small lesions and highlight its robustness across different training schemes for large stroke lesions. Our code is available at: https://github.com/nadluru/StrokeLesSeg.