Learn how to leverage generative AI to support and improve your productivity at work. The next cohort will take place online on April 28 and 30, 2026, in French.
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Background: Quantitative MRI biomarkers in spinal cord injury (SCI) can help understand the extent of the focal injury. However, due to the … (see more)lack of automatic segmentation methods, these biomarkers are derived manually, which is a time-consuming process prone to intra- and inter-rater variability, thus limiting large multi-site studies and translation to clinical workflows. Purpose: To develop a deep learning tool for the automatic segmentation of T2-weighted hyperintense lesions and the spinal cord in SCI patients. Material and Methods: This retrospective study included a cohort of SCI patients from three sites enrolled between July 2002 and February 2023 who underwent clinical MRI examination. A deep learning model, SCIseg, was trained on T2-weighted images with heterogeneous image resolutions (isotropic, anisotropic), and orientations (axial, sagittal) acquired using scanners from different manufacturers (Siemens, Philips, GE) and different field strengths (1T, 1.5T, 3T) for the automatic segmentation of SCI lesions and the spinal cord. The proposed method was visually and quantitatively compared with other open-source baseline methods. Quantitative biomarkers (lesion volume, lesion length, and maximal axial damage ratio) computed from manual ground-truth lesion masks and automatic SCIseg predictions were correlated with clinical scores (pinprick, light touch, and lower extremity motor scores). A between-group comparison was performed using the Wilcoxon signed-rank test. Results: MRI data from 191 SCI patients (mean age, 48.1 years {+/-} 17.9 [SD]; 142 males) were used for training. Compared to existing methods, SCIseg achieved the best segmentation performance for both the cord and lesions and generalized well to both traumatic and non-traumatic SCI patients. SCIseg is open-source and accessible through the Spinal Cord Toolbox. Conclusion: Automatic segmentation of intramedullary lesions commonly seen in traumatic SCI replaces the tedious manual annotation process and enables the extraction of relevant lesion morphometrics in large cohorts. The proposed model generalizes across lesion etiologies (traumatic, ischemic), scanner manufacturers and heterogeneous image resolutions.