Relating Acute Lesion Loads to Chronic Outcome in Ischemic Stroke-An Exploratory Comparison of Mismatch Patterns and Predictive Modeling.

Habegger, Simon; Wiest, Roland; Weder, Bruno; Mordasini, Pasquale; Gralla, Jan; Häni, Levin; Jung, Simon; Reyes, Mauricio; McKinley, Richard (2018). Relating Acute Lesion Loads to Chronic Outcome in Ischemic Stroke-An Exploratory Comparison of Mismatch Patterns and Predictive Modeling. Frontiers in neurology, 9(737), p. 737. Frontiers Media S.A. 10.3389/fneur.2018.00737

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To investigate the relationship between imaging features derived from lesion loads and 3 month clinical assessments in ischemic stroke patients. To support clinically implementable predictive modeling with information from lesion-load features. A retrospective cohort of ischemic stroke patients was studied. The dataset was dichotomized based on revascularization treatment outcome (TICI score). Three lesion delineations were derived from magnetic resonance imaging in each group: two clinically implementable (threshold based and fully automatic prediction) and 90-day follow-up as final groundtruth. Lesion load imaging features were created through overlay of the lesion delineations on a histological brain atlas, and were correlated with the clinical assessment (NIHSS). Significance of the correlations was assessed by constructing confidence intervals using bootstrap sampling. Overall, high correlations between lesion loads and clinical score were observed (up to 0.859). Delineations derived from acute imaging yielded on average somewhat lower correlations than delineations derived from 90-day follow-up imaging. Correlations suggest that both total lesion volume and corticospinal tract lesion load are associated with functional outcome, and in addition highlight other potential areas associated with poor clinical outcome, including the primary somatosensory cortex BA3a. Fully automatic prediction was comparable to ADC threshold-based delineation on the successfully treated cohort and superior to the Tmax threshold-based delineation in the unsuccessfully treated cohort. The confirmation of established predictors for stroke outcome (e.g., corticospinal tract integrity and total lesion volume) gives support to the proposed methodology-relating acute lesion loads to 3 month outcome assessments by way of correlation. Furthermore, the preliminary results indicate an association of further brain regions and structures with three month NIHSS outcome assessments. Hence, prediction models might observe an increased accuracy when incorporating regional (instead of global) lesion loads. Also, the results lend support to the clinical utilization of the automatically predicted volumes from FASTER, rather than the simpler DWI and PWI lesion delineations.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Surgical Technology & Biomechanics ISTB
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Habegger, Simon; Wiest, Roland; Weder, Bruno; Mordasini, Pasquale; Gralla, Jan; Häni, Levin; Jung, Simon; Reyes, Mauricio and McKinley, Richard

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

1664-2295

Publisher:

Frontiers Media S.A.

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

08 Oct 2018 07:40

Last Modified:

24 Oct 2019 12:06

Publisher DOI:

10.3389/fneur.2018.00737

PubMed ID:

30254601

Uncontrolled Keywords:

FASTER atlas-based regional image analysis correlation lesion load stroke recovery

BORIS DOI:

10.7892/boris.120349

URI:

https://boris.unibe.ch/id/eprint/120349

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