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However, current automated approaches for lesion detection and segmentation are typically designed for specific MRI contrasts or acquisition sites, limiting their generalizability in real-world clinical settings where imaging protocols vary widely. This work proposes a robust multi-site, multi-contrast segmentation framework for spinal cord lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The segmentation model was trained and evaluated on a large-scale dataset comprising 4428 annotated images from 1849 persons with MS across 23 imaging centers, encompassing six MRI contrasts (T1w, T2w, T2*w, PSIR, STIR, and UNIT1) acquired at 1.5\u2009tesla (T), 3\u2009T, and 7\u2009T.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Likert-type assessment performed by neuroradiologist ratings demonstrated superior generalization of the model compared to existing contrast-specific pipelines (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Additional experiments evaluated robustness across spinal levels, acquisition resolutions, binarization thresholds, and quantitative evaluation on external labeled datasets.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The proposed model can achieve accurate and reliable spinal cord MS lesion segmentation across heterogeneous MRI data, addressing a key barrier to clinical translation. The model is available in the Spinal Cord Toolbox v7.2 and higher.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Code repository:<\/jats:bold>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/github.com\/ivadomed\/seg-sc-ms-lesion-multicontrast\">https:\/\/github.com\/ivadomed\/seg-sc-ms-lesion-multicontrast<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585261427333","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T10:50:18Z","timestamp":1777027818000},"page":"598-613","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Generalizable spinal cord multiple sclerosis lesion segmentation across MRI contrasts, protocols, and centers"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3122-1957","authenticated-orcid":false,"given":"Pierre-Louis","family":"Benveniste","sequence":"first","affiliation":[{"name":"NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada; Mila\u2014Quebec AI Institute, Montreal, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurent","family":"L\u00e9tourneau-Guillon","sequence":"additional","affiliation":[{"name":"Centre de Recherche du Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al (CHUM), Montr\u00e9al, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1600-6138","authenticated-orcid":false,"given":"David","family":"Araujo","sequence":"additional","affiliation":[{"name":"McConnell Brain Imaging Center, McGill, Montr\u00e9al, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lydia","family":"Chougar","sequence":"additional","affiliation":[{"name":"The Neuro\u2014Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada; Department of Neuroradiology, Sorbonne Universit\u00e9, Institut du Cerveau\u2014Paris Brain Institute\u2014ICM, AP-HP, CNRS, Inserm, H\u00f4pital de la Piti\u00e9 Salp\u00eatri\u00e8re, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1335-8274","authenticated-orcid":false,"given":"Dumitru","family":"Fetco","sequence":"additional","affiliation":[{"name":"McConnell Brain Imaging Center, McGill University, Montr\u00e9al, QC, Canada; NeuroRx, A Clario Company, Montr\u00e9al, QC, Canada; 7T MRI MS Working Group, North American Imaging in MS, MNI, Montr\u00e9al, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1791-8032","authenticated-orcid":false,"given":"Masaaki","family":"Hori","sequence":"additional","affiliation":[{"name":"Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kouhei","family":"Kamiya","sequence":"additional","affiliation":[{"name":"Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Messina","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charidimos","family":"Tsagkas","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Basel, University of Basel, Basel, Switzerland; 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Mark","family":"Keegan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4530-3553","authenticated-orcid":false,"given":"Anne","family":"Kerbrat","sequence":"additional","affiliation":[{"name":"Univ Rennes, Inria, CNRS, Inserm, IRISA UMR 6074, Visages U1128, Rennes, France; Radiology Department, CHU Rennes, Rennes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7557-0003","authenticated-orcid":false,"given":"Jan","family":"Kirschke","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, TUM School of Medicine and Health, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1362-1968","authenticated-orcid":false,"given":"Shannon","family":"Kolind","sequence":"additional","affiliation":[{"name":"Departments of Medicine (Neurology), Physics, Radiology, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Labauge","sequence":"additional","affiliation":[{"name":"MS Unit, Department of Neurology, University Hospital of Montpellier, Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8334-3740","authenticated-orcid":false,"given":"Lisa Eunyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada; 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