Royal Adelaide Hospital, Australia.
Royal Adelaide Hospital, Australia; Faculty of Health and Medical Sciences, University of Adelaide, Australia.
Acad Radiol. 2020 Feb;27(2):e19-e23. doi: 10.1016/j.acra.2019.03.015. Epub 2019 Apr 30.
RATIONALE AND OBJECTIVES: Intravenous thrombolysis decision-making and obtaining of consent would be assisted by an individualized risk-benefit ratio. Deep learning (DL) models may be able to assist with this patient selection. MATERIALS AND METHODS: Clinical data regarding consecutive patients who received intravenous thrombolysis across two tertiary hospitals over a 7-year period were extracted from existing databases. The noncontrast computed tomography brain scans for these patients were then retrieved with hospital picture archiving and communication systems. Using a combination of convolutional neural networks (CNN) and artificial neural networks (ANN) several models were developed to predict either improvement in the National Institutes of Health Stroke Scale of ≥4 points at 24 hours ("NIHSS24"), or modified Rankin Scale 0-1 at 90 days ("mRS90"). The developed CNN and ANN were then applied to a test set. The THRIVE, HIAT, and SPAN-100 scores were also calculated for the patients in the test set and used to predict NIHSS24 and mRS90. RESULTS: Data from 204 individuals were included in the project. The best performing DL model for prediction of mRS90 was a combination CNN + ANN based on clinical data and computed tomography brain (accuracy = 0.74, F1 score = 0.69). The best performing model for NIHSS24 prediction was also the combination CNN + ANN (accuracy = 0.71, F1 score = 0.74). CONCLUSION: DL models may aid in the prediction of functional thrombolysis outcomes. Further investigation with larger datasets and additional imaging sequences is indicated.
背景与目的:通过个体化风险效益比,可以辅助进行静脉溶栓治疗的决策制定和获得知情同意。深度学习(DL)模型可能有助于进行这种患者选择。
材料与方法:从两家三级医院的现有数据库中提取了连续接受静脉溶栓治疗的患者的临床数据。然后使用医院图像存档和通信系统检索这些患者的非对比计算机断层扫描脑扫描。使用卷积神经网络(CNN)和人工神经网络(ANN)的组合,开发了几种模型来预测 24 小时内美国国立卫生研究院卒中量表(NIHSS)评分提高≥4 分(“NIHSS24”),或 90 天改良 Rankin 量表(mRS)0-1 分(“mRS90”)。将开发的 CNN 和 ANN 应用于测试集。还计算了 THRIVE、HIAT 和 SPAN-100 评分,并用于预测 NIHSS24 和 mRS90。
结果:该项目纳入了 204 名个体的数据。用于预测 mRS90 的表现最佳的 DL 模型是基于临床数据和计算机断层扫描脑的 CNN+ANN 组合(准确率=0.74,F1 分数=0.69)。用于预测 NIHSS24 的表现最佳的模型也是 CNN+ANN 组合(准确率=0.71,F1 分数=0.74)。
结论:DL 模型可能有助于预测功能溶栓治疗的结局。需要进一步进行更大数据集和额外成像序列的研究。
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