Cargando…

Image Patch-Based Net Water Uptake and Radiomics Models Predict Malignant Cerebral Edema After Ischemic Stroke

Malignant cerebral edema (MCE) after an ischemic stroke results in a poor outcome or death. Early prediction of MCE helps to identify subjects that could benefit from a surgical decompressive craniectomy. Net water uptake (NWU) in an ischemic lesion is a predictor of MCE; however, CT perfusion and l...

Descripción completa

Detalles Bibliográficos
Autores principales: Fu, Bowen, Qi, Shouliang, Tao, Lin, Xu, Haibin, Kang, Yan, Yao, Yudong, Yang, Benqiang, Duan, Yang, Chen, Huisheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7786250/
https://www.ncbi.nlm.nih.gov/pubmed/33424759
http://dx.doi.org/10.3389/fneur.2020.609747
_version_ 1783632587502125056
author Fu, Bowen
Qi, Shouliang
Tao, Lin
Xu, Haibin
Kang, Yan
Yao, Yudong
Yang, Benqiang
Duan, Yang
Chen, Huisheng
author_facet Fu, Bowen
Qi, Shouliang
Tao, Lin
Xu, Haibin
Kang, Yan
Yao, Yudong
Yang, Benqiang
Duan, Yang
Chen, Huisheng
author_sort Fu, Bowen
collection PubMed
description Malignant cerebral edema (MCE) after an ischemic stroke results in a poor outcome or death. Early prediction of MCE helps to identify subjects that could benefit from a surgical decompressive craniectomy. Net water uptake (NWU) in an ischemic lesion is a predictor of MCE; however, CT perfusion and lesion segmentation are required. This paper proposes a new Image Patch-based Net Water Uptake (IP-NWU) procedure that only uses non-enhanced admission CT and does not need lesion segmentation. IP-NWU is calculated by comparing the density of ischemic and contralateral normal patches selected from the middle cerebral artery (MCA) area using standard reference images. We also compared IP-NWU with the Segmented Region-based NWU (SR-NWU) procedure in which segmented ischemic regions from follow-up CT images are overlaid onto admission images. Furthermore, IP-NWU and its combination with imaging features are used to construct predictive models of MCE with a radiomics approach. In total, 116 patients with an MCA infarction (39 with MCE and 77 without MCE) were included in the study. IP-NWU was significantly higher for patients with MCE than those without MCE (p < 0.05). IP-NWU can predict MCE with an AUC of 0.86. There was no significant difference between IP-NWU and SR-NWU, nor between their predictive efficacy for MCE. The inter-reader and interoperation agreement of IP-NWU was exceptional according to the Intraclass Correlation Coefficient (ICC) analysis (inter-reader: ICC = 0.92; interoperation: ICC = 0.95). By combining IP-NWU with imaging features through a random forest classifier, the radiomics model achieved the highest AUC (0.96). In summary, IP-NWU and radiomics models that combine IP-NWU with imaging features can precisely predict MCE using only admission non-enhanced CT images scanned within 24 h from onset.
format Online
Article
Text
id pubmed-7786250
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-77862502021-01-07 Image Patch-Based Net Water Uptake and Radiomics Models Predict Malignant Cerebral Edema After Ischemic Stroke Fu, Bowen Qi, Shouliang Tao, Lin Xu, Haibin Kang, Yan Yao, Yudong Yang, Benqiang Duan, Yang Chen, Huisheng Front Neurol Neurology Malignant cerebral edema (MCE) after an ischemic stroke results in a poor outcome or death. Early prediction of MCE helps to identify subjects that could benefit from a surgical decompressive craniectomy. Net water uptake (NWU) in an ischemic lesion is a predictor of MCE; however, CT perfusion and lesion segmentation are required. This paper proposes a new Image Patch-based Net Water Uptake (IP-NWU) procedure that only uses non-enhanced admission CT and does not need lesion segmentation. IP-NWU is calculated by comparing the density of ischemic and contralateral normal patches selected from the middle cerebral artery (MCA) area using standard reference images. We also compared IP-NWU with the Segmented Region-based NWU (SR-NWU) procedure in which segmented ischemic regions from follow-up CT images are overlaid onto admission images. Furthermore, IP-NWU and its combination with imaging features are used to construct predictive models of MCE with a radiomics approach. In total, 116 patients with an MCA infarction (39 with MCE and 77 without MCE) were included in the study. IP-NWU was significantly higher for patients with MCE than those without MCE (p < 0.05). IP-NWU can predict MCE with an AUC of 0.86. There was no significant difference between IP-NWU and SR-NWU, nor between their predictive efficacy for MCE. The inter-reader and interoperation agreement of IP-NWU was exceptional according to the Intraclass Correlation Coefficient (ICC) analysis (inter-reader: ICC = 0.92; interoperation: ICC = 0.95). By combining IP-NWU with imaging features through a random forest classifier, the radiomics model achieved the highest AUC (0.96). In summary, IP-NWU and radiomics models that combine IP-NWU with imaging features can precisely predict MCE using only admission non-enhanced CT images scanned within 24 h from onset. Frontiers Media S.A. 2020-12-23 /pmc/articles/PMC7786250/ /pubmed/33424759 http://dx.doi.org/10.3389/fneur.2020.609747 Text en Copyright © 2020 Fu, Qi, Tao, Xu, Kang, Yao, Yang, Duan and Chen. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Fu, Bowen
Qi, Shouliang
Tao, Lin
Xu, Haibin
Kang, Yan
Yao, Yudong
Yang, Benqiang
Duan, Yang
Chen, Huisheng
Image Patch-Based Net Water Uptake and Radiomics Models Predict Malignant Cerebral Edema After Ischemic Stroke
title Image Patch-Based Net Water Uptake and Radiomics Models Predict Malignant Cerebral Edema After Ischemic Stroke
title_full Image Patch-Based Net Water Uptake and Radiomics Models Predict Malignant Cerebral Edema After Ischemic Stroke
title_fullStr Image Patch-Based Net Water Uptake and Radiomics Models Predict Malignant Cerebral Edema After Ischemic Stroke
title_full_unstemmed Image Patch-Based Net Water Uptake and Radiomics Models Predict Malignant Cerebral Edema After Ischemic Stroke
title_short Image Patch-Based Net Water Uptake and Radiomics Models Predict Malignant Cerebral Edema After Ischemic Stroke
title_sort image patch-based net water uptake and radiomics models predict malignant cerebral edema after ischemic stroke
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7786250/
https://www.ncbi.nlm.nih.gov/pubmed/33424759
http://dx.doi.org/10.3389/fneur.2020.609747
work_keys_str_mv AT fubowen imagepatchbasednetwateruptakeandradiomicsmodelspredictmalignantcerebraledemaafterischemicstroke
AT qishouliang imagepatchbasednetwateruptakeandradiomicsmodelspredictmalignantcerebraledemaafterischemicstroke
AT taolin imagepatchbasednetwateruptakeandradiomicsmodelspredictmalignantcerebraledemaafterischemicstroke
AT xuhaibin imagepatchbasednetwateruptakeandradiomicsmodelspredictmalignantcerebraledemaafterischemicstroke
AT kangyan imagepatchbasednetwateruptakeandradiomicsmodelspredictmalignantcerebraledemaafterischemicstroke
AT yaoyudong imagepatchbasednetwateruptakeandradiomicsmodelspredictmalignantcerebraledemaafterischemicstroke
AT yangbenqiang imagepatchbasednetwateruptakeandradiomicsmodelspredictmalignantcerebraledemaafterischemicstroke
AT duanyang imagepatchbasednetwateruptakeandradiomicsmodelspredictmalignantcerebraledemaafterischemicstroke
AT chenhuisheng imagepatchbasednetwateruptakeandradiomicsmodelspredictmalignantcerebraledemaafterischemicstroke