Share：
Share this content in WeChat
X
[Chinese][PDF]691
• Clinical Article •
The study of MRI perfusion imaging global and local radiomics in the prediction of outcome in acute stroke
ZHOU Xiaohu  PENG Mingyang  WANG Tongxing  CHEN Guozhong  YIN Xindao  REN Jun 

Cite this article as: ZHOU X H, PENG M Y, WANG T X, et al. The study of MRI perfusion imaging global and local radiomics in the prediction of outcome in acute stroke[J]. Chin J Magn Reson Imaging, 2024, 15(10): 98-102, 135. DOI:10.12015/issn.1674-8034.2024.10.017.


[Abstract] Objective To investigate the predicting value of local and global brain radiomics of MR perfusion weighted imaging (PWI) in the outcome of acute stroke after endovascular.Materials and Methods A total of 180 acute stroke patients with PWI images in our hospital were retrospectively enrolled. The ITK-SNAP software was used to segment the regions of interest of abnormal perfusion areas in Tmax. The SPM software was used to automatically segment the global brain in Tmax. The AK software was used to extract the local and global brain radiomics and reduce the dimensionality. The support vector machine classifier was used to construct the models for predicting the outcome of acute stroke, and further searching for the optimal prediction model.Results After least absolute shrinkage and selection operator (LASSO) dimensionality reduction, there are 6 local features, 5 global brain features, and 10 combined local and global brain features that are highly related to outcome. Receiver operating characteristic (ROC) analysis showed that area under the curve (AUC) of the outcome prediction model based on both local and global brain features was 0.900, with the sensitivity and specificity were 82.3% and 89.1% respectively, which is significantly better than the local features model (AUC=0.706; Z=-3.248; P=0.001) and the global brain features (AUC=0.711; Z=-3.393; P<0.001).Conclusions Combining local and global PWI features can more accurately predict the outcome of acute stroke patients and provide personalized guidance for early clinical intervention.
[Keywords] stroke；outcome；perfusion weighted imaging；magnetic resonance imaging；radiomics；machine learning

ZHOU Xiaohu   PENG Mingyang   WANG Tongxing   CHEN Guozhong   YIN Xindao   REN Jun*  

Department of Medical Imaging, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

Corresponding author: REN J, E-mail: renjun1203@163.com

Conflicts of interest   None.

Received  2024-04-24
Accepted  2024-10-10
DOI: 10.12015/issn.1674-8034.2024.10.017
Cite this article as: ZHOU X H, PENG M Y, WANG T X, et al. The study of MRI perfusion imaging global and local radiomics in the prediction of outcome in acute stroke[J]. Chin J Magn Reson Imaging, 2024, 15(10): 98-102, 135. DOI:10.12015/issn.1674-8034.2024.10.017.

[1]
CONSOLI A, GORY B. Long-term results of mechanical thrombectomy for large ischaemic stroke[J]. Lancet, 2024, 403(10428): 700-701. DOI: 10.1016/S0140-6736(24)00158-2.
[2]
FESKE S K. Ischemic stroke[J]. Am J Med, 2021, 134(12): 1457-1464. DOI: 10.1016/j.amjmed.2021.07.027.
[3]
The Chinese Stroke Society, the Neurointerventional Branch of the Chinese Stroke Society, the Interventional Group of the Stroke Prevention and Control Professional Committee of the Chinese Preventive Medicine Association. Chinese Guidelines for Endovascular Treatment of Acute Ischemic Stroke 2023[J]. Chin J Stroke, 2023, 18(6): 684-711. DOI: 10.3969/j.issn.1673-5765.2023.06.010.
[4]
SARRAJ A, HASSAN A E, ABRAHAM M G, et al. Endovascular thrombectomy for large ischemic stroke across ischemic injury and penumbra profiles[J]. JAMA, 2024, 331(9): 750-763. DOI: 10.1001/jama.2024.0572.
[5]
LIU J, NIE X, ZHANG Z, et al. Association of blood pressure and outcomes differs upon cerebral perfusion post-thrombectomy in patients with acute ischemic stroke[J/OL]. J Neurointerv Surg, 2024: jnis-2024-021487 [2024-04-24]. https://jnis.bmj.com/content/early/2024/05/02/jnis-2024-021487.long. DOI: 10.1136/jnis-2024-021487.
[6]
YANG W, KIM J M, SOHN C H, et al. Global hyperperfusion after successful endovascular thrombectomy is linked to worse outcome in acute ischemic stroke[J/OL]. Sci Rep, 2024, 14(1): 10024 [2024-04-24]. https://pmc.ncbi.nlm.nih.gov/articles/PMC11063193/. DOI: 10.1038/s41598-024-60623-4.
[7]
GHARAIBEH K, ALADAMAT N, MIERZWA A T, et al. Blood pressure after successful endovascular therapy: A systematic review and meta-analysis of randomized control trials[J]. Ann Neurol, 2024, 95(5): 858-865. DOI: 10.1002/ana.26907.
[8]
MARVEL Trial Authors for the MARVEL Investigators; Yang Q, Guo C, et al. Methylprednisolone as adjunct to endovascular thrombectomy for large-vessel occlusion stroke: The MARVEL randomized clinical trial[J/OL]. JAMA, 2024: e240626 [2024-04-24]. https://pmc.ncbi.nlm.nih.gov/articles/PMC10853866/. DOI: 10.1001/jama.2024.0626.
[9]
LIM J, AGUIRRE A O, RATTANI A, et al. Thrombectomy outcomes for acute ischemic stroke in lower-middle income countries: A systematic review and analysis[J/OL]. World Neurosurg X, 2024, 23: 100317 [2024-04-24]. https://pmc.ncbi.nlm.nih.gov/articles/PMC10950731/. DOI: 10.1016/j.wnsx.2024.100317.
[10]
POHLMANN J E, KIM I S Y, BRUSH B, et al. Association of large core middle cerebral artery stroke and hemorrhagic transformation with hospitalization outcomes[J/OL]. Sci Rep. 2024, 14(1): 10008 [2024-04-24]. https://pmc.ncbi.nlm.nih.gov/articles/PMC11063151/. DOI: 10.1038/s41598-024-60635-0.
[11]
WANG T, JIN X, YANG P, et al. A clinical and computed tomography-based nomogram to predict the outcome in patients with anterior circulation large vessel occlusion after endovascular mechanical thrombectomy[J]. Jpn J Radiol, 2024, 42(9): 973-982. DOI: 10.1007/s11604-024-01583-7.
[12]
WANG X L, WANG X, WANG M D, et al. The value of modified MRI-DRAGON score in predicting the outcome of acute ischemic stroke after endovascular treatment[J]. Chin J Magn Reson Imaging, 2023, 14(3): 134-139. DOI: 10.12015/issn.1674-8034.2023.03.023.
[13]
OSPEL J M, RINKEL L, GANESH A, et al. Influence of infarct morphology and patterns on cognitive outcomes after endovascular thrombectomy[J]. Stroke, 2024, 55(5): 1349-1358. DOI: 10.1161/STROKEAHA.123.045825.
[14]
JIANG L, MIAO Z, CHEN H, et al. Radiomics analysis of diffusion-weighted imaging and long-term unfavorable outcomes risk for acute stroke[J]. Stroke, 2023, 54(2): 488-498. DOI: DOI:10.1161/STROKEAHA.122.040418.
[15]
GUPTA R, BILGIN C, JABAL M S, et al. Quality assessment of radiomics studies on functional outcomes after acute ischemic stroke-A systematic review[J]. World Neurosurg. 2024, 183: 164-171. DOI: 10.1016/j.wneu.2023.11.154.
[16]
RINKEL L A, OSPEL J M, BROWN S B, et al. What is a meaningful difference when using infarct volume as the primary outcome?: Results from the HERMES database[J]. Stroke, 2024, 55(4): 866-873. DOI: 10.1161/STROKEAHA.123.044353.
[17]
GANESH A, OSPEL J M, MENON B K, et al. Assessment of discrepancies between follow-up infarct volume and 90-day outcomes among patients with ischemic stroke who received endovascular therapy[J/OL]. JAMA Netw Open, 2021, 4(11): e2132376 [2024-04-24]. https://pmc.ncbi.nlm.nih.gov/articles/PMC8571657/. DOI: 10.1001/jamanetworkopen.2021.32376.
[18]
OUYANG F, WANG B, CHEN Y, et al. Research progress of magnetic resonance imaging in predicting the prognosis of acute ischemic stroke[J]. Chin J Magn Reson Imaging, 2022, 13(7): 147-151. DOI: 10.12015/issn.1674-8034.2022.07.029.
[19]
JIANG C, CHEN D N, CHEN B L, et al. Prognosis in elderly stroke patients with atrial fibrillation after endovascular therapy[J]. Chinese Journal of Geriatric Heart Brain and Vessel Diseases, 2023, 25(4): 348-352. DOI: 10.3969/j.issn.1009-0126.2023.04.004.
[20]
XIE D, HUANG J, FAN S, et al. Endovascular therapy and outcomes among patients with very large ischemic core stroke[J/OL]. JAMA Netw Open, 2024, 7(5): e249298 [2024-04-24]. https://pmc.ncbi.nlm.nih.gov/articles/PMC11066696/. DOI: 10.1001/jamanetworkopen.2024.9298.
[21]
OLIVEIRA F A A, DOURADO-FILHO M G, SAMPAIO ROCHA-FILHO P A. Assessing the influence of migraine on ischemic penumbra and on the prognosis of ischemic stroke: A prospective cohort study[J]. Headache, 2023, 63(4): 549-558. DOI: 10.1111/head.14492.
[22]
PISTOCCHI S, STRAMBO D, BARTOLINI B, et al. MRI software for diffusion-perfusion mismatch analysis may impact on patients' selection and clinical outcome[J]. Eur Radiol, 2022, 32(2): 1144-1153. DOI: 10.1007/s00330-021-08211-2.
[23]
MORENO-NAVARRO L, FARRERONS-LLOPART M, LÓPEZ- HERNÁNDEZ N, et al. Clinicoradiological application of the use of spectral cranial computed tomography in the management of acute ischemic stroke after mechanical thrombectomy[J]. Rev Neurol, 2024, 78(9): 247-252. DOI: 10.33588/rn.7809.2023340.
[24]
PANICKER S, WILSECK Z M, LIN L Y, et al. CT imaging computed tomography/Computed tomography angiography/Perfusion in acute ischemic stroke and vasospasm[J]. Neuroimaging Clin N Am, 2024, 34(2): 175-189. DOI: 10.1016/j.nic.2024.01.004.
[25]
GUO Y, YANG Y, CAO F, et al. A focus on the role of DSC-PWI dynamic radiomics features in diagnosis and outcome prediction of ischemic stroke[J/OL]. J Clin Med, 2022, 11(18): 5364 [2024-04-24]. https://pubmed.ncbi.nlm.nih.gov/36143010/. DOI: 10.3390/jcm11185364.
[26]
HEO J, SIM Y, KIM B M, et al. Radiomics using non-contrast CT to predict hemorrhagic transformation risk in stroke patients undergoing revascularization[J]. Eur Radiol, 2024, 34(9): 6005-6016. DOI: 10.1007/s00330-024-10618-6.
[27]
KONG J, ZHANG D. Current status and quality of radiomics studies for predicting outcome in acute ischemic stroke patients: a systematic review and meta-analysis[J/OL]. Front Neurol. 2024, 14: 1335851 [2024-04-24]. https://pmc.ncbi.nlm.nih.gov/articles/PMC10789857/. DOI: 10.3389/fneur.2023.1335851.
[28]
LIU Z, ZHANG S, WANG Y, et al. Posterior circulation ischemic stroke: radiomics-based machine learning approach to identify onset time from magnetic resonance imaging[J]. Neuroradiology, 2024, 66(7): 1141-1152. DOI: 10.1007/s00234-024-03353-8.
[29]
WEI L, PAN X, DENG W, et al. Predicting long-term outcomes for acute ischemic stroke using multi-model MRI radiomics and clinical variables[J/OL]. Front Med (Lausanne), 2024, 11: 1328073 [2024-04-24]. https://pmc.ncbi.nlm.nih.gov/articles/PMC10940383/. DOI: 10.3389/fmed.2024.1328073.
[30]
GOLDEN D I, LIPSON J A, TELLI M L, et al. Dynamic contrast-enhanced MRI-based biomarkers of therapeutic response in triple-negative breast cancer[J]. J Am Med Inform Assoc, 2013, 20(6): 1059-1066. DOI: 10.1136/amiajnl-2012-001460.
[31]
PAIN C, KRIECHBAUMER V, KITTELMANN M, et al. Quantitative analysis of plant ER architecture and dynamics[J/OL]. Nat Commun, 2019, 10(1): 984 [2024-04-24]. https://pmc.ncbi.nlm.nih.gov/articles/PMC6395764/. DOI: 10.1038/s41467-019-08893-9.
[32]
DEVKOTA L, STAROSOLSKI Z, RIVAS C H, et al. Detection of response to tumor microenvironment-targeted cellular immunotherapy using nano-radiomics[J/OL]. Sci Adv.2020, 6(28): eaba6156 [2024-04-24]. https://pmc.ncbi.nlm.nih.gov/articles/PMC7439308/. DOI: 10.1126/sciadv.aba6156.
[33]
CHEN X, HUANG Y, HE L, et al. CT-based radiomics to differentiate pelvic rhabdomyosarcoma from yolk sac tumors in children[J/OL]. Front Oncol, 2020, 10: 584272 [2024-04-24]. https://pmc.ncbi.nlm.nih.gov/articles/PMC7732637/. DOI: 10.3389/fonc.2020.584272.
[34]
YANG T H, SU Y Y, TSAI C L, et al. Magnetic resonance imaging-based deep learning imaging biomarker for predicting functional outcomes after acute ischemic stroke[J/OL]. Eur J Radiol, 2024, 174: 111405 [2024-04-24]. https://www.sciencedirect.com/science/article/pii/S0720048X24001219?via%3Dihub. DOI: 10.1016/j.ejrad.2024.111405.
[35]
DING L, LIU H, JING J, et al. Lesion network mapping for neurological deficit in acute ischemic stroke[J]. Ann Neurol, 2023, 94(3): 572-584. DOI: 10.1002/ana.26721.
[36]
JIANG L, ZHOU L, YONG W, et al. A deep learning-based model for prediction of hemorrhagic transformation after stroke[J/OL]. Brain Pathol, 2023, 33(2): e13023 [2024-04-24]. https://pmc.ncbi.nlm.nih.gov/articles/PMC10041160/. DOI: 10.1111/bpa.13023.

PREV Analysis of thalamic glutamate-glutamine complex metabolism and related factors in patients with vestibular migraine
NEXT Prediction based on CE-T1WI omics and pathological parameter models research on postoperative recurrence of glioma
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn