Noninvasive model for predicting future ischemic strokes in patients with silent lacunar infarction using radiomics

BMC Medical Imaging

Jie Tian¹  Wen-yan Zhuo²  Jie-hua Su²  Li-bin Liu²  Zhao-hui Li²  Yi Qin³  Ye Tian⁴  Jian-ming Wang⁴  Di Dong⁵  Ling-wei Meng⁵ 

[1] CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences;Department of Neurology, Zhuhai Hospital Affiliated with Jinan University;Department of Orthopedics, Zhuhai Hospital Affiliated with Jinan University;Department of Radiology, Zhuhai People’s Hospital;School of Artificial Intelligence, University of Chinese Academy of Sciences;

关键词: Stroke;    Infarction;    Radiomics;    Tomography;    X-ray computed;   

DOI  :  10.1186/s12880-020-00470-7

来源: DOAJ

【 摘 要 】

Abstract Background This study aimed to investigate integrating radiomics with clinical factors in cranial computed tomography (CT) to predict ischemic strokes in patients with silent lacunar infarction (SLI). Methods Radiomic features were extracted from baseline cranial CT images of patients with SLI. A least absolute shrinkage and selection operator (LASSO)–Cox regression analysis was used to select significant prognostic factors based on ModelC with clinical factors, ModelR with radiomic features, and ModelCR with both factors. The Kaplan–Meier method was used to compare stroke-free survival probabilities. A nomogram and a calibration curve were used for further evaluation. Results Radiomic signature (p < 0.01), age (p = 0.09), dyslipidemia (p = 0.03), and multiple infarctions (p = 0.02) were independently associated with future ischemic strokes. ModelCR had the best accuracy with 6-, 12-, and 18-month areas under the curve of 0.84, 0.81, and 0.79 for the training cohort and 0.79, 0.88, and 0.75 for the validation cohort, respectively. Patients with a ModelCR score < 0.17 had higher probabilities of stroke-free survival. The prognostic nomogram and calibration curves of the training and validation cohorts showed acceptable discrimination and calibration capabilities (concordance index [95% confidence interval]: 0.7864 [0.70–0.86]; 0.7140 [0.59–0.83], respectively). Conclusions Radiomic analysis based on baseline CT images may provide a novel approach for predicting future ischemic strokes in patients with SLI. Older patients and those with dyslipidemia or multiple infarctions are at higher risk for ischemic stroke and require close monitoring and intensive intervention.

【 授权许可】

Unknown