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Tissue Outcome Prediction in Patients with Proximal Vessel Occlusion and Mechanical Thrombectomy Using Logistic Models

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Název: Tissue Outcome Prediction in Patients with Proximal Vessel Occlusion and Mechanical Thrombectomy Using Logistic Models
Autoři: Welle, Florian, Stoll, Kristin, Gillmann, Christina, Henkelmann, Jeanette, Prasse, Gordian, Kaiser, Daniel P. O., Kellner, Elias, Reisert, Marco, Schneider, Hans R., Klingbeil, Julian, Stockert, Anika, Lobsien, Donald, Hoffmann, Karl-Titus, Saur, Dorothee, Wawrzyniak, Max
Zdroj: Transl Stroke Res
Informace o vydavateli: Springer Science and Business Media LLC, 2023.
Rok vydání: 2023
Témata: Male, Aged, 80 and over, Research, Middle Aged, Cerebral Angiography, Stroke, Logistic Models, Treatment Outcome, Humans, Female, Female [MeSH], Stroke/therapy [MeSH], Tissue outcome, Computed tomography, Aged, 80 and over [MeSH], Aged [MeSH], Thrombectomy/methods [MeSH], Humans [MeSH], Perfusion, Treatment Outcome [MeSH], Logistic Models [MeSH], Middle Aged [MeSH], Prediction, Stroke/surgery [MeSH], Tomography, X-Ray Computed [MeSH], Male [MeSH], Cerebral Angiography/methods [MeSH], Stroke/diagnostic imaging [MeSH], Tomography, X-Ray Computed, Aged, Thrombectomy
Popis: Perfusion CT is established to aid selection of patients with proximal intracranial vessel occlusion for thrombectomy in the extended time window. Selection is mostly based on simple thresholding of perfusion parameter maps, which, however, does not exploit the full information hidden in the high-dimensional perfusion data. We implemented a multiparametric mass-univariate logistic model to predict tissue outcome based on data from 405 stroke patients with acute proximal vessel occlusion in the anterior circulation who underwent mechanical thrombectomy. Input parameters were acute multimodal CT imaging (perfusion, angiography, and non-contrast) as well as basic demographic and clinical parameters. The model was trained with the knowledge of recanalization status and final infarct localization. We found that perfusion parameter maps (CBF, CBV, and Tmax) were sufficient for tissue outcome prediction. Compared with single-parameter thresholding-based models, our logistic model had comparable volumetric accuracy, but was superior with respect to topographical accuracy (AUC of receiver operating characteristic). We also found higher spatial accuracy (Dice index) in an independent internal but not external cross-validation. Our results highlight the value of perfusion data compared with non-contrast CT, CT angiography and clinical information for tissue outcome-prediction. Multiparametric logistic prediction has high potential to outperform the single-parameter thresholding-based approach. In the future, the combination of tissue and functional outcome prediction might provide an individual biomarker for the benefit from mechanical thrombectomy in acute stroke care.
Druh dokumentu: Article
Other literature type
Popis souboru: pdf
Jazyk: English
ISSN: 1868-601X
1868-4483
DOI: 10.1007/s12975-023-01160-6
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/37249761
https://repository.publisso.de/resource/frl:6505270
Rights: CC BY
Přístupové číslo: edsair.doi.dedup.....e5a64e63416d3c8711dc2d099b441261
Databáze: OpenAIRE
Popis
Abstrakt:Perfusion CT is established to aid selection of patients with proximal intracranial vessel occlusion for thrombectomy in the extended time window. Selection is mostly based on simple thresholding of perfusion parameter maps, which, however, does not exploit the full information hidden in the high-dimensional perfusion data. We implemented a multiparametric mass-univariate logistic model to predict tissue outcome based on data from 405 stroke patients with acute proximal vessel occlusion in the anterior circulation who underwent mechanical thrombectomy. Input parameters were acute multimodal CT imaging (perfusion, angiography, and non-contrast) as well as basic demographic and clinical parameters. The model was trained with the knowledge of recanalization status and final infarct localization. We found that perfusion parameter maps (CBF, CBV, and Tmax) were sufficient for tissue outcome prediction. Compared with single-parameter thresholding-based models, our logistic model had comparable volumetric accuracy, but was superior with respect to topographical accuracy (AUC of receiver operating characteristic). We also found higher spatial accuracy (Dice index) in an independent internal but not external cross-validation. Our results highlight the value of perfusion data compared with non-contrast CT, CT angiography and clinical information for tissue outcome-prediction. Multiparametric logistic prediction has high potential to outperform the single-parameter thresholding-based approach. In the future, the combination of tissue and functional outcome prediction might provide an individual biomarker for the benefit from mechanical thrombectomy in acute stroke care.
ISSN:1868601X
18684483
DOI:10.1007/s12975-023-01160-6