Prognostic value of radiomics-based hyperdense middle cerebral artery sign for patients with acute ischemic stroke after thrombectomy strategy

Linna Li; Mingyang Li; Zhongping Chen; Fei Lu; Min Zhao; Huimao Zhang; Dan Tong

doi:10.3389/fneur.2022.1037204

Prognostic value of radiomics-based hyperdense middle cerebral artery sign for patients with acute ischemic stroke after thrombectomy strategy

Front Neurol. 2023 Jan 13:13:1037204. doi: 10.3389/fneur.2022.1037204. eCollection 2022.

Authors

Linna Li¹, Mingyang Li¹, Zhongping Chen¹, Fei Lu¹, Min Zhao², Huimao Zhang¹, Dan Tong¹

Affiliations

¹ Department of Radiology, The First Hospital of Jilin University, Changchun, Jilin, China.
² Pharmaceutical Diagnostics, GE Healthcare, Beijing, China.

Abstract

Background and purpose: The purpose of this study was to evaluate the prognostic value of radiomics-based hyperdense middle cerebral artery sign (HMCAS) for patients with acute ischemic stroke (AIS) after mechanical thrombectomy (MT) and to establish prediction models to identify patients who may benefit more from MT.

Methods: In this retrospective study, a total of 102 consecutive patients who presented with HMCAS on non-contrast computed tomography (NCCT) at admission and underwent MT in our hospital between January 2019 and December 2020 were recruited. Among them, 46 experienced favorable outcomes (modified Rankin Scale [mRS] ≤ 2) at 3 months of follow-up. All patients were categorized into two sets, namely, the training set (n = 81) and the test set (n = 21). Radiomics features (RFs) and clinical features (CFs) in the training set were selected by statistical analysis to create models. The models' discriminative ability was quantified using the area under the curve (AUC) and confirmed by decision curve analyses.

Results: The prediction model established using CFs before MT includes baseline National Institutes of Health Stroke Scale (NIHSS) and neutrophil-to-lymphocyte ratio (NLR) [AUC [95% confidence interval (CI)] = 0.596 (0.312-0.881)]. A total of 1,389 RFs were extracted from each hyperdense territory and 8 RFs were left to build the radiomics model [RM; AUC (95%CI) = 0.798 (0.598-0.998)]. The model using preoperative CFs and RFs showed good performance [AUC (95%CI) = 0.817 (0.625-1.000)]. The models using post-operative CFs alone [AUC (95%CI) = 0.856 (0.685-1.000)] or post-operative CFs with RFs [AUC (95%CI) = 0.894 (0.757-1.000)] also showed good discrimination.

Conclusion: The radiomics-based HMCAS might be a promising tool to predict the prognoses of patients with AIS after MT.

Keywords: acute ischemic stroke; hyperdense middle cerebral artery; mechanical thrombectomy; prognostic factor; radiomics.

Grants and funding

This study received funding from the Jilin Province Special Scientific Research Project of Health (2018SCZWSZX-001) and the Jilin Province Science and Technology Development Plan Project (20200201303JC), with additional funding support received from the Jilin Provincial Key Laboratory of Medical Imaging and Big Data (20200601003JC), the Radiology and Technology Innovation Center of Jilin Province (20190902016TC), and the National Natural Science Foundation of China (NSFC) (82102143).