The value of radiomics-based hyperdense middle cerebral artery sign in predicting hemorrhagic transformation in acute ischemic stroke patients undergoing endovascular treatment

ObjectiveTo establish and validate a model based on hyperdense middle cerebral artery sign (HMCAS) radiomics features for predicting hemorrhagic transformation (HT) in patients with acute ischemic stroke (AIS) after endovascular treatment (EVT).MethodsPatients with AIS who presented with HMCAS on no...

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Main Authors: Chundan Gong, Yun Liu, Wei Ma, Yang Jing, Li Liu, Yan Huang, Jinlin Yang, Chen Feng, Yuan Fang, Weidong Fang
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2024.1492089/full
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author Chundan Gong
Chundan Gong
Yun Liu
Wei Ma
Yang Jing
Li Liu
Yan Huang
Jinlin Yang
Chen Feng
Yuan Fang
Weidong Fang
author_facet Chundan Gong
Chundan Gong
Yun Liu
Wei Ma
Yang Jing
Li Liu
Yan Huang
Jinlin Yang
Chen Feng
Yuan Fang
Weidong Fang
author_sort Chundan Gong
collection DOAJ
description ObjectiveTo establish and validate a model based on hyperdense middle cerebral artery sign (HMCAS) radiomics features for predicting hemorrhagic transformation (HT) in patients with acute ischemic stroke (AIS) after endovascular treatment (EVT).MethodsPatients with AIS who presented with HMCAS on non-contrast computed tomography (NCCT) at admission and underwent EVT at three comprehensive hospitals between June 2020 and January 2024 were recruited for this retrospective study. A radiomics model was constructed using the HMCAS radiomics features most strongly associated with HT. In addition, clinical and radiological independent factors associated with HT were identified. Subsequently, a combined model incorporating radiomics features and independent risk factors was developed via multivariate logistic regression and presented as a nomogram. The models were evaluated via receiver operating characteristic curve, calibration curve, and decision curve analysis.ResultsOf the 118 patients, 71 (60.17%) developed HT. The area under the curve (AUC) of the radiomics model was 0.873 (95% CI 0.797–0.935) in the training cohort and 0.851 (95%CI 0.721–0.942) in the test cohort. The Alberta Stroke Program Early CT score (ASPECTS) was the only independent predictor among 24 clinical and 4 radiological variables. The combined model further improved the predictive performance, with an AUC of 0.911 (95%CI 0.850–0.960) in the training cohort and 0.877 (95%CI 0.753–0.960) in the test cohort. Decision curve analysis demonstrated that the combined model had greater clinical utility for predicting HT.ConclusionHMCAS-based radiomics is expected to be a reliable tool for predicting HT risk stratification in AIS patients after EVT.
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spelling doaj-art-3c4345999fcc42ae92b0bc5d86461eb32025-08-20T02:40:24ZengFrontiers Media S.A.Frontiers in Neurology1664-22952024-12-011510.3389/fneur.2024.14920891492089The value of radiomics-based hyperdense middle cerebral artery sign in predicting hemorrhagic transformation in acute ischemic stroke patients undergoing endovascular treatmentChundan Gong0Chundan Gong1Yun Liu2Wei Ma3Yang Jing4Li Liu5Yan Huang6Jinlin Yang7Chen Feng8Yuan Fang9Weidong Fang10Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Radiology, The People's Hospital of Yubei District of Chongqing City, Chongqing, ChinaMedical Imaging Department, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, ChinaDepartment of Radiology, The People's Hospital of Yubei District of Chongqing City, Chongqing, ChinaHuiying Medical Technology Co., Ltd., Beijing, ChinaDepartment of Radiology, The People's Hospital of Yubei District of Chongqing City, Chongqing, ChinaDepartment of Radiology, The People's Hospital of Yubei District of Chongqing City, Chongqing, ChinaDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Radiology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, ChinaDepartment of Radiology, The People's Hospital of Yubei District of Chongqing City, Chongqing, ChinaDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaObjectiveTo establish and validate a model based on hyperdense middle cerebral artery sign (HMCAS) radiomics features for predicting hemorrhagic transformation (HT) in patients with acute ischemic stroke (AIS) after endovascular treatment (EVT).MethodsPatients with AIS who presented with HMCAS on non-contrast computed tomography (NCCT) at admission and underwent EVT at three comprehensive hospitals between June 2020 and January 2024 were recruited for this retrospective study. A radiomics model was constructed using the HMCAS radiomics features most strongly associated with HT. In addition, clinical and radiological independent factors associated with HT were identified. Subsequently, a combined model incorporating radiomics features and independent risk factors was developed via multivariate logistic regression and presented as a nomogram. The models were evaluated via receiver operating characteristic curve, calibration curve, and decision curve analysis.ResultsOf the 118 patients, 71 (60.17%) developed HT. The area under the curve (AUC) of the radiomics model was 0.873 (95% CI 0.797–0.935) in the training cohort and 0.851 (95%CI 0.721–0.942) in the test cohort. The Alberta Stroke Program Early CT score (ASPECTS) was the only independent predictor among 24 clinical and 4 radiological variables. The combined model further improved the predictive performance, with an AUC of 0.911 (95%CI 0.850–0.960) in the training cohort and 0.877 (95%CI 0.753–0.960) in the test cohort. Decision curve analysis demonstrated that the combined model had greater clinical utility for predicting HT.ConclusionHMCAS-based radiomics is expected to be a reliable tool for predicting HT risk stratification in AIS patients after EVT.https://www.frontiersin.org/articles/10.3389/fneur.2024.1492089/fullradiomicshyperdense middle cerebral artery signhemorrhagic transformationacute ischemic strokeendovascular treatment
spellingShingle Chundan Gong
Chundan Gong
Yun Liu
Wei Ma
Yang Jing
Li Liu
Yan Huang
Jinlin Yang
Chen Feng
Yuan Fang
Weidong Fang
The value of radiomics-based hyperdense middle cerebral artery sign in predicting hemorrhagic transformation in acute ischemic stroke patients undergoing endovascular treatment
Frontiers in Neurology
radiomics
hyperdense middle cerebral artery sign
hemorrhagic transformation
acute ischemic stroke
endovascular treatment
title The value of radiomics-based hyperdense middle cerebral artery sign in predicting hemorrhagic transformation in acute ischemic stroke patients undergoing endovascular treatment
title_full The value of radiomics-based hyperdense middle cerebral artery sign in predicting hemorrhagic transformation in acute ischemic stroke patients undergoing endovascular treatment
title_fullStr The value of radiomics-based hyperdense middle cerebral artery sign in predicting hemorrhagic transformation in acute ischemic stroke patients undergoing endovascular treatment
title_full_unstemmed The value of radiomics-based hyperdense middle cerebral artery sign in predicting hemorrhagic transformation in acute ischemic stroke patients undergoing endovascular treatment
title_short The value of radiomics-based hyperdense middle cerebral artery sign in predicting hemorrhagic transformation in acute ischemic stroke patients undergoing endovascular treatment
title_sort value of radiomics based hyperdense middle cerebral artery sign in predicting hemorrhagic transformation in acute ischemic stroke patients undergoing endovascular treatment
topic radiomics
hyperdense middle cerebral artery sign
hemorrhagic transformation
acute ischemic stroke
endovascular treatment
url https://www.frontiersin.org/articles/10.3389/fneur.2024.1492089/full
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