Frontiers in neurology · 2024
The value of radiomics-based hyperdense middle cerebral artery sign in predicting hemorrhagic transformation in acute ischemic stroke patients undergoing endovascular treatment.
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Gong Chundan, Liu Yun, Ma Wei, Jing Yang, Liu Li, Huang Yan, Yang Jinlin, Feng Chen, Fang Yuan, Fang Weidong
Аннотация
OBJECTIVE: To establish and validate a model based on hyperdense middle cerebral artery sign (HMCAS) radiomics features for predicting hemorrhagic transformation (HT) in patients with acute ischemic stroke (AIS) after endovascular treatment (EVT).
METHODS: Patients with AIS who presented with HMCAS on non-contrast computed tomography (NCCT) at admission and underwent EVT at three comprehensive hospitals between June 2020 and January 2024 were recruited for this retrospective study. A radiomics model was constructed using the HMCAS radiomics features most strongly associated with HT. In addition, clinical and radiological independent factors associated with HT were identified. Subsequently, a combined model incorporating radiomics features and independent risk factors was developed via multivariate logistic regression and presented as a nomogram. The models were evaluated via receiver operating characteristic curve, calibration curve, and decision curve analysis.
RESULTS: Of the 118 patients, 71 (60.17%) developed HT. The area under the curve (AUC) of the radiomics model was 0.873 (95% CI 0.797-0.935) in the training cohort and 0.851 (95%CI 0.721-0.942) in the test cohort. The Alberta Stroke Program Early CT score (ASPECTS) was the only independent predictor among 24 clinical and 4 radiological variables. The combined model further improved the predictive performance, with an AUC of 0.911 (95%CI 0.850-0.960) in the training cohort and 0.877 (95%CI 0.753-0.960) in the test cohort. Decision curve analysis demonstrated that the combined model had greater clinical utility for predicting HT.
CONCLUSION: HMCAS-based radiomics is expected to be a reliable tool for predicting HT risk stratification in AIS patients after EVT.
METHODS: Patients with AIS who presented with HMCAS on non-contrast computed tomography (NCCT) at admission and underwent EVT at three comprehensive hospitals between June 2020 and January 2024 were recruited for this retrospective study. A radiomics model was constructed using the HMCAS radiomics features most strongly associated with HT. In addition, clinical and radiological independent factors associated with HT were identified. Subsequently, a combined model incorporating radiomics features and independent risk factors was developed via multivariate logistic regression and presented as a nomogram. The models were evaluated via receiver operating characteristic curve, calibration curve, and decision curve analysis.
RESULTS: Of the 118 patients, 71 (60.17%) developed HT. The area under the curve (AUC) of the radiomics model was 0.873 (95% CI 0.797-0.935) in the training cohort and 0.851 (95%CI 0.721-0.942) in the test cohort. The Alberta Stroke Program Early CT score (ASPECTS) was the only independent predictor among 24 clinical and 4 radiological variables. The combined model further improved the predictive performance, with an AUC of 0.911 (95%CI 0.850-0.960) in the training cohort and 0.877 (95%CI 0.753-0.960) in the test cohort. Decision curve analysis demonstrated that the combined model had greater clinical utility for predicting HT.
CONCLUSION: HMCAS-based radiomics is expected to be a reliable tool for predicting HT risk stratification in AIS patients after EVT.