Outcome prediction based on automatically extracted infarct core image features in patients with acute ischemic stroke

Tolhuisen, M. L. et al. (2022) Outcome prediction based on automatically extracted infarct core image features in patients with acute ischemic stroke. Diagnostics, 12(8), 1786. (doi: 10.3390/diagnostics12081786) (PMID:35892499) (PMCID:PMC9331690)

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Infarct volume (FIV) on follow-up diffusion-weighted imaging (FU-DWI) is only moderately associated with functional outcome in acute ischemic stroke patients. However, FU-DWI may contain other imaging biomarkers that could aid in improving outcome prediction models for acute ischemic stroke. We included FU-DWI data from the HERMES, ISLES, and MR CLEAN-NO IV databases. Lesions were segmented using a deep learning model trained on the HERMES and ISLES datasets. We assessed the performance of three classifiers in predicting functional independence for the MR CLEAN-NO IV trial cohort based on: (1) FIV alone, (2) the most important features obtained from a trained convolutional autoencoder (CAE), and (3) radiomics. Furthermore, we investigated feature importance in the radiomic-feature-based model. For outcome prediction, we included 206 patients: 144 scans were included in the training set, 21 in the validation set, and 41 in the test set. The classifiers that included the CAE and the radiomic features showed AUC values of 0.88 and 0.81, respectively, while the model based on FIV had an AUC of 0.79. This difference was not found to be statistically significant. Feature importance results showed that lesion intensity heterogeneity received more weight than lesion volume in outcome prediction. This study suggests that predictions of functional outcome should not be based on FIV alone and that FU-DWI images capture additional prognostic information.

Item Type:Articles
Keywords:Acute ischemic stroke, functional independence, follow-up DWI, infarct core image features, infarct core segmentation, support vector machine.
Glasgow Author(s) Enlighten ID:Muir, Professor Keith
Creator Roles:
Muir, K. W.Resources, Writing – review and editing, Funding acquisition
Authors: Tolhuisen, M. L., Hoving, J. W., Koopman, M. S., Kappelhof, M., van Voorst, H., Bruggeman, A. E., Demchuck, A. M., Dippel, D. W. J., Emmer, B. J., Bracard, S., Guillemin, F., van Oostenbrugge, R. J., Mitchell, P. J., van Zwam, W. H., Hill, M. D., Roos, Y. B. W. E. M., Jovin, T. G., Berkhemer, O. A., Campbell, B. C. V., Saver, J., White, P., Muir, K. W., Goyal, M., Marquering, H. A., Majoie, C. B., and Caan, M. W. A.
College/School:College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience
Journal Name:Diagnostics
ISSN (Online):2075-4418
Published Online:23 July 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in Diagnostics 12(8): 1786
Publisher Policy:Reproduced under a Creative Commons License

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