Prediction of the mean transit time using machine learning models based on radiomics features from digital subtraction angiography in moyamoya disease or moyamoya syndrome-a development and validation model study

Kun Qin; Zhige Guo; Chao Peng; Wu Gan; Dong Zhou; Guangzhong Chen

doi:10.21037/cdt-23-151

Prediction of the mean transit time using machine learning models based on radiomics features from digital subtraction angiography in moyamoya disease or moyamoya syndrome-a development and validation model study

Cardiovasc Diagn Ther. 2023 Oct 31;13(5):879-892. doi: 10.21037/cdt-23-151. Epub 2023 Oct 26.

Authors

Kun Qin^#¹, Zhige Guo^#¹, Chao Peng¹, Wu Gan¹, Dong Zhou¹, Guangzhong Chen¹

Affiliation

¹ Department of Neurosurgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.

^# Contributed equally.

Abstract

Background: Digital subtraction angiography (DSA) is an important technique for diagnosis of moyamoya disease (MMD) or moyamoya syndrome (MMS), and computed tomography perfusion (CTP) is essential for assessing intracranial blood supply. The aim of this study was to assess whether radiomics features based on images of DSA could predict the mean transit time (MTT; outcome of CTP) using machine learning models.

Methods: The DSA images and MTT values of adult patients with MMD or MMS, according to the diagnostic guidelines for MMD, as well as control cases, were retrospectively collected in the Guangdong Provincial People's Hospital between January 2018 and December 2020. A total of 93 features were extracted from the images of each case through 3-dimensional (3D) slicer. After features preprocessing and filtering, 3-4 features were selected by the least absolute shrinkage and selection operator (LASSO) regression algorithm. Prediction models were established using random forest (RF) and support vector machine (SVM) for MTT values. Single-factor receiver operating characteristic (ROC) curve analysis and partial-dependence (PD) profiles were conducted to investigate selected features and prediction models.

Results: Our results showed that prediction models based on RF models had the best performance in frontal lobe {area under the curve (AUC) [95% confidence interval (CI)] =1.000 (1.000-1.000)], parietal lobe [AUC (95% CI) =1.000 (1.000-1.000)], and basal ganglia/thalamus [AUC (95% CI) =0.922 (0.797-1.000)] in the test set, whereas the SVM model performed the best in the temporal lobe [AUC (95% CI) =0.962 (0.876-1.000)] in the test set. The AUC values in the test set were greater than 0.9. The PD profiles showed good robustness and consistency.

Conclusions: Prediction models based on radiomics features extracted from DSA images demonstrate excellent performance in predicting MTT in patients with MMD or MMS, which may provide guidance for future clinical practice.

Keywords: Moyamoya disease (MMD); computed tomography perfusion (CTP); digital subtraction angiography (DSA); machine learning; radiomics.