Machine learning models of segmentation in acute ischemic stroke: a systematic review and meta-analysis
Abstract
Background: Accurate segmentation of acute ischemic stroke (AIS) lesions on neuroimaging is essential for diagnosis, treatment decision-making, and prognostication. Manual methods are limited by time and variability. Machine learning (ML), especially deep learning, has emerged as a powerful tool for automated lesion segmentation, yet a systematic synthesis of model performance, methodological rigor, and clinical applicability remains lacking.
Objective: To systematically review and quantitatively evaluate the performance of ML-based segmentation models for AIS using a meta-analytic approach, and to identify factors associated with model accuracy and robustness across imaging modalities, architectures, and datasets.
Methods: We conducted a systematic review and meta-analysis in accordance with PRISMA 2020 guidelines. Comprehensive searches were performed in PubMed, Scopus, and Web of Science databases through March 2025. Eligible studies included those reporting on machine learning (ML)-based segmentation of acute ischemic stroke (AIS) lesions on CT or MRI and providing quantitative performance metrics (e.g., Dice, sensitivity, specificity, AUC). Data were systematically extracted on study design, ML architecture, imaging modality, dataset size and composition, and segmentation performance. Random-effects meta-analyses were conducted using inverse-variance weighting, with logit transformation applied to bounded metrics to stabilize variance. Between-study heterogeneity was…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in computer models (in silico), not in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Active Learning during Federated Learning for Object Detection
- Fairness-aware federated learning
- Decentralized Federated Learning
- Building a Personally Identifiable Information Recognizer in a Privacy Preserved Manner Using Automated Annotation and Federated Learning
- Preservation of Patient Level Privacy: Federated Classification and Calibration Models
- Efficient explainable federated learning
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.