Prediction of hemorrhagic transformation after experimental ischemic stroke using MRI-based algorithms.

ABSTRACT: Estimation of hemorrhagic transformation (HT) risk is crucial for treatment decision-making after acute ischemic stroke. We aimed to determine the accuracy of multiparametric MRI-based predictive algorithms in calculating probability of HT after stroke. Spontaneously, hypertensive rats were subjected to embolic stroke and, after 3?h treated with tissue plasminogen activator (Group I: n?=?6) or vehicle (Group II: n?=?7). Brain MRI measurements of T2, T2*, diffusion, perfusion, and blood-brain barrier permeability were obtained at 2, 24, and 168?h post-stroke. Generalized linear model and random forest (RF) predictive algorithms were developed to calculate the probability of HT and infarction from acute MRI data. Validation against seven-day outcome on MRI and histology revealed that highest accuracy of hemorrhage prediction was achieved with a RF-based model that included spatial brain features (Group I: area under the receiver-operating characteristic curve (AUC)?=?0.85?±?0.14; Group II: AUC?=?0.89?±?0.09), with significant improvement over perfusion- or permeability-based thresholding methods. However, overlap between predicted and actual tissue outcome was significantly lower for hemorrhage prediction models (maximum Dice's Similarity Index (DSI)?=?0.20?±?0.06) than for infarct prediction models (maximum DSI?=?0.81?±?0.06). Multiparametric MRI-based predictive algorithms enable early identification of post-ischemic tissue at risk of HT and may contribute to improved treatment decision-making after acute ischemic stroke.

SUBMITTER: Bouts MJ 

PROVIDER: S-EPMC5536810 | biostudies-other | 2017 Aug

REPOSITORIES: biostudies-other