Stroke Lesion Segmentation in Clinical Workflows: A Modular, Lightweight, and Deployment-Ready Tool

Deep learning frameworks such as nnU-Net achieve state-of-the-art performance in brain lesion segmentation but remain difficult to deploy clinically due to heavy dependencies and monolithic design. We introduce textitStrokeSeg, a modular and lightweight framework that translates research-grade stroke lesion segmentation models into deployable applications. Preprocessing, inference, and postprocessing are decoupled: preprocessing relies on the Anima toolbox with BIDS-compliant outputs, and inference uses ONNX Runtime with textttFloat16 quantisation, reducing model size by about 50%. textitStrokeSeg provides both graphical and command-line interfaces and is distributed as Python scripts and as a standalone Windows executable. On a held-out set of 300 sub-acute and chronic stroke subjects, segmentation performance was equivalent to the original PyTorch pipeline (Dice difference <10-3), demonstrating that high-performing research pipelines can be transformed into portable, clinically usable tools.