Stroke: Quantitative Imaging-Guided Approaches

A special issue of Tomography (ISSN 2379-139X).

Deadline for manuscript submissions: 31 December 2024 | Viewed by 5958

Special Issue Editor


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Guest Editor
1. Department of Radiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, 10117 Berlin, Germany
2. Berlin Institute of Health (BIH), BIH Biomedical Innovation Academy, Berlin, Germany
Interests: ischemic stroke; hemorrhagic stroke; outcome prediction; diagnosis prediction; quantitative-imaging-based models for prediction; computed tomography imaging-based radiomic models; deep learning in the imaging study of stroke
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Special Issue Information

Dear Colleagues,

Stroke remains a major cause of morbidity and mortality worldwide. While imaging-guided therapy in acute ischemic stroke is aimed at identifying further subpopulations to benefit from endovascular interventions, imaging-guided tailored treatment in hemorrhagic stroke has mainly focused on evaluating acute hematoma expansion as it presents a potentially therapeutic target. In quantitative imaging (QI), components of the pathological mechanisms involved in both stroke types can be used as potential biomarkers to further improve the current limitations of imaging-guided therapies; thus, further studies investigating biomarkers are needed. At the same time, artificial intelligence (AI) will lead to significant advances in the QI of stroke within the next decade by exploring even deeper image information. This Special Issue focuses on the development and clinical role of QI and AI advances in the precise diagnosis and individualized treatment decision in acute ischemic and hemorrhagic stroke patients.

Dr. Jawed Nawabi
Guest Editor

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Keywords

  • ischemic stroke
  • hemorrhagic stroke
  • intracerebral hemorrhage
  • quantitative imaging
  • outcome prediction
  • intelligent segmentation
  • focus detection
  • lesion prediction
  • machine learning
  • deep learning

Published Papers (2 papers)

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Research

9 pages, 3924 KiB  
Article
Multilesion Segmentations in Patients with Intracerebral Hemorrhage: Reliability of ICH, IVH and PHE Masks
by Estelle Vogt, Ly Huong Vu, Haoyin Cao, Anna Speth, Dmitriy Desser, Frieder Schlunk, Andrea Dell’Orco and Jawed Nawabi
Tomography 2023, 9(1), 89-97; https://doi.org/10.3390/tomography9010008 - 11 Jan 2023
Cited by 1 | Viewed by 1826
Abstract
Background and Purpose: Fully automated methods for segmentation and volume quantification of intraparenchymal hemorrhage (ICH), intraventricular hemorrhage extension (IVH), and perihematomal edema (PHE) are gaining increasing interest. Yet, reliabilities demonstrate considerable variances amongst each other. Our aim was therefore to evaluate both the [...] Read more.
Background and Purpose: Fully automated methods for segmentation and volume quantification of intraparenchymal hemorrhage (ICH), intraventricular hemorrhage extension (IVH), and perihematomal edema (PHE) are gaining increasing interest. Yet, reliabilities demonstrate considerable variances amongst each other. Our aim was therefore to evaluate both the intra- and interrater reliability of ICH, IVH and PHE on ground-truth segmentation masks. Methods: Patients with primary spontaneous ICH were retrospectively included from a German tertiary stroke center (Charité Berlin; January 2016–June 2020). Baseline and follow-up non-contrast Computed Tomography (NCCT) scans were analyzed for ICH, IVH, and PHE volume quantification by two radiology residents. Raters were blinded to all demographic and outcome data. Inter- and intrarater agreements were determined by calculating the Intraclass Correlation Coefficient (ICC) for a randomly selected set of patients with ICH, IVH, and PHE. Results: 100 out of 670 patients were included in the analysis. Interrater agreements ranged from an ICC of 0.998 for ICH (95% CI [0.993; 0.997]), to an ICC of 0.979 for IVH (95% CI [0.984; 0.993]), and an ICC of 0.886 for PHE (95% CI [0.760; 0.938]), all p-values < 0.001. Intrarater agreements ranged from an ICC of 0.997 for ICH (95% CI [0.996; 0.998]), to an ICC of 0.995 for IVH (95% CI [0.992; 0.996]), and an ICC of 0.980 for PHE (95% CI [0.971; 0.987]), all p-values < 0.001. Conclusion Manual segmentations of ICH, IVH, and PHE demonstrate good-to-excellent inter- and intrarater reliabilities, with the highest agreement for ICH and IVH and lowest for PHE. Therefore, the degree of variances reported in fully automated quantification methods might be related amongst others to variances in ground-truth masks. Full article
(This article belongs to the Special Issue Stroke: Quantitative Imaging-Guided Approaches)
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9 pages, 1589 KiB  
Article
Diagnostic Accuracy and Reliability of Noncontrast Computed Tomography Markers for Acute Hematoma Expansion among Radiologists
by Hawra Almubarak, Sarah Elsayed, Federico Mazzacane, Frieder Schlunk, Haoyin Cao, Ly Huong Vu, Estelle Vogt, Andrea Dell Orco, Dmitriy Desser, Maik F. H. Böhmer, Burak Han Akkurt, Peter B. Sporns, Tobias Penzkofer, Uta Hanning, Andrea Morotti and Jawed Nawabi
Tomography 2022, 8(6), 2893-2901; https://doi.org/10.3390/tomography8060242 - 9 Dec 2022
Cited by 1 | Viewed by 3208
Abstract
Background: Noncontrast Computed Tomography (NCCT) features are promising markers for acute hematoma expansion (HE) in patients with intracerebral hemorrhage (ICH). It remains unclear whether accurate identification of these markers is also reliable in raters with different levels of experience. Methods: Patients with acute [...] Read more.
Background: Noncontrast Computed Tomography (NCCT) features are promising markers for acute hematoma expansion (HE) in patients with intracerebral hemorrhage (ICH). It remains unclear whether accurate identification of these markers is also reliable in raters with different levels of experience. Methods: Patients with acute spontaneous ICH admitted at four tertiary centers in Germany and Italy were retrospectively included from January 2017 to June 2020. In total, nine NCCT markers were rated by one radiology resident, one radiology fellow, and one neuroradiology fellow with different levels experience in ICH imaging. Interrater reliabilities of the resident and radiology fellow were evaluated by calculated Cohen’s kappa (κ) statistics in reference to the neuroradiology fellow who was referred as the gold standard. Gold-standard ratings were evaluated by calculated interrater κ statistics. Global interrater reliabilities were evaluated by calculated Fleiss kappa statistics across all three readers. A comparison of receiver operating characteristics (ROCs) was used to evaluate differences in the diagnostic accuracy for predicting acute hematoma expansion (HE) among the raters. Results: Substantial-to-almost-perfect interrater concordance was found for the resident with interrater Cohen’s kappa from 0.70 (95% CI 0.65–0.81) to 0.96 (95% CI 0.94–0.98). The interrater Cohen’s kappa for the radiology fellow was moderate to almost perfect and ranged from 0.58 (95% CI 0.52–0.65) to 94 (95% CI 92–0.97). The intrarater gold-standard Cohen’s kappa was almost perfect and ranged from 0.79 (95% CI 0.78–0.90) to 0.98 (95% CI 0.78–0.90). The global interrater Fleiss kappa ranged from 0.62 (95%CI 0.57–0.66) to 0.93 (95%CI 0.89–0.97). The diagnostic accuracy for the prediction of acute hematoma expansion (HE) was different for the island sign and fluid sign, with p-values < 0.05. Conclusion: The NCCT markers had a substantial-to-almost-perfect interrater agreement among raters with different levels of experience. Differences in the diagnostic accuracy for the prediction of acute HE were found in two out of nine NCCT markers. The study highlights the promising utility of NCCT markers for acute HE prediction. Full article
(This article belongs to the Special Issue Stroke: Quantitative Imaging-Guided Approaches)
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