A Novel Attention-Augmented Wavelet YOLO System for Real-time Brain Vessel Segmentation on Transcranial Color-coded Doppler

The Circle of Willis (CoW), vital for ensuring consistent blood flow to the brain, is closely linked to ischemic stroke. Accurate assessment of the CoW is important for identifying individuals at risk and guiding appropriate clinical management. Among existing imaging methods, Transcranial Color-coded Doppler (TCCD) offers unique advantages due to its radiation-free nature, affordability, and accessibility. However, reliable TCCD assessments depend heavily on operator expertise for identifying anatomical landmarks and performing accurate angle correction, which limits its widespread adoption. To address this challenge, we propose an AI-powered, real-time CoW auto-segmentation system capable of efficiently capturing cerebral arteries. No prior studies have explored AI-driven cerebrovascular segmentation using TCCD. In this work, we introduce a novel Attention-Augmented Wavelet YOLO (AAW-YOLO) network tailored for TCCD data, designed to provide real-time guidance for brain vessel segmentation in the CoW. We prospectively collected TCCD data comprising 738 annotated frames and 3,419 labeled artery instances to establish a high-quality dataset for model training and evaluation. The proposed AAW-YOLO demonstrated strong performance in segmenting both ipsilateral and contralateral CoW vessels, achieving an average Dice score of 0.901, IoU of 0.823, precision of 0.882, recall of 0.926, and mAP of 0.953, with a per-frame inference speed of 14.199 ms. This system offers a practical solution to reduce reliance on operator experience in TCCD-based cerebrovascular screening, with potential applications in routine clinical workflows and resource-constrained settings. Future research will explore bilateral modeling and larger-scale validation.