Predicting Functional Outcomes of Endovascular Thrombectomy in Acute Ischemic Stroke Using a Clinical-Radiomics Nomogram.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-10-28 DOI:10.1016/j.wneu.2024.10.073

Yuan Zhang, Tingting Zheng, Hao Wang, Jie Zhu, Shaofeng Duan, Bin Song

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引用次数: 0

Abstract

Background: Endovascular thrombectomy (EVT) is recommended for acute ischemic stroke (AIS) due to large-vessel occlusion. However, approximately 50% of patients still face poor outcomes post-procedure. This study aimed to assess whether a nomogram model that integrates CT angiography radiomics features and clinical variables can predict EVT outcomes in AIS patients.

Methods: 159 EVT patients were randomly divided into training and validation groups at a 7:3 ratio. A modified Rankin Scale (mRS) ≤ 2 at 90 days indicated a favorable outcome. We used univariate and multivariate logistic regression to identify analytic and radiomic predictors and create predictive models. Model performance was evaluated using the AUC, Hosmer-Lemeshow test, and decision curve analysis for discrimination, calibration, and clinical utility.

Results: A 19-feature radiomic signature reached an AUC of 0.79. Combining it with age, baseline NIHSS, diabetes, and statin use raised the clinical-radiomics nomogram's AUC to 0.85. Both decision curve and calibration curve analyses showed strong performance.

Conclusion: Combining radiomics nomogram with clinical predictors could effectively forecast EVT outcomes in acute anterior circulation large vessel occlusion stroke patients.

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利用临床放射组学提名图预测急性缺血性脑卒中血管内血栓切除术的功能性结果

背景：对于大血管闭塞导致的急性缺血性卒中（AIS），建议采用血管内血栓切除术（EVT）。然而，约 50% 的患者在术后仍面临不良预后。本研究旨在评估一个整合了 CT 血管造影放射组学特征和临床变量的提名图模型能否预测 AIS 患者的 EVT 结果。90天时改良Rankin量表（mRS）≤2表示预后良好。我们使用单变量和多变量逻辑回归来确定分析和放射学预测因素，并创建预测模型。我们使用AUC、Hosmer-Lemeshow检验和决策曲线分析对模型的辨别、校准和临床实用性进行了评估：结果：19 个特征的放射学特征的 AUC 为 0.79。将其与年龄、基线 NIHSS、糖尿病和他汀类药物的使用相结合，临床放射组学提名图的 AUC 提高到了 0.85。决策曲线和校准曲线分析均显示出良好的性能：结论：将放射组学提名图与临床预测指标相结合可有效预测急性前循环大血管闭塞性卒中患者的EVT预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.