Accuracy, Precision, Sensitivity, and Specificity of Noninvasive ICP Absolute Value Measurements

Krakauskaite, Solventa; Petkus, Vytautas; Bartušis, Laimonas; Žakelis, Rolandas; Chomskis, Romanas; Preikšaitis, Aidanas; Ragauskas, Arminas; Matijošaitis, Vaidas; Petrikonis, Kęstutis; Rastenytė, Daiva

doi:10.1007/978-3-319-22533-3_63

Cited by 12 publications

(6 citation statements)

References 14 publications

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“…this method was reported to have better diagnostic reliability for detecting elevated ICP compared to optic nerve sheath diameter measurement [66][67][68][69]. An independent clinical validation study determined that this technique had a fair agreement to ICP measured using lumbar puncture [70].…”

Section: Plos Onementioning

confidence: 97%

A machine learning approach in the non-invasive prediction of intracranial pressure using Modified Photoplethysmography

Abdul-Rahman

Morgan

2022

PLoS ONE

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The ideal Intracranial pressure (ICP) estimation method should be accurate, reliable, cost-effective, compact, and associated with minimal morbidity/mortality. To this end several described non-invasive methods in ICP estimation have yielded promising results, however the reliability of these techniques have yet to supersede invasive methods of ICP measurement. Over several publications, we described a novel imaging method of Modified Photoplethysmography in the evaluation of the retinal vascular pulse parameters decomposed in the Fourier domain, which enables computationally efficient information filtering of the retinal vascular pulse wave. We applied this method in a population of 21 subjects undergoing lumbar puncture manometry. A regression model was derived by applying an Extreme Gradient Boost (XGB) machine learning algorithm using retinal vascular pulse harmonic regression waveform amplitude (HRWa), first and second harmonic cosine and sine coefficients (an1,2, bn1,2) among other features. Gain and SHapley Additive exPlanation (SHAP) values ranked feature importance in the model. Agreement between the predicted ICP mean, median and peak density with measured ICP was assessed using Bland-Altman bias±standard error. Feature gain of intraocular pressure (IOPi) (arterial = 0.6092, venous = 0.5476), and of the Fourier coefficients, an1 (arterial = 0.1000, venous = 0.1024) ranked highest in the XGB model for both vascular systems. The arterial model SHAP values demonstrated the importance of the laterality of the tested eye (1.2477), which was less prominent in the venous model (0.8710). External validation was achieved using seven hold-out test cases, where the median venous predicted ICP showed better agreement with measured ICP. Although the Bland-Altman bias from the venous model (0.034±1.8013 cm water (p<0.99)) was lower compared to that of the arterial model (0.139±1.6545 cm water (p<0.94)), the arterial model provided a potential avenue for internal validation of the prediction. This approach can potentially be integrated into a neurological clinical decision algorithm to evaluate the indication for lumbar puncture.

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Section: Plos Onementioning

confidence: 97%

A machine learning approach in the non-invasive prediction of intracranial pressure using Modified Photoplethysmography

Abdul-Rahman

Morgan

2022

PLoS ONE

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“…Ragauskas et al [ 161 , 162 , 163 , 164 ] introduced a two-depth Doppler approach with excellent accuracy and reliability in initial studies (including a Bland–Altman-Plot). The approach uses a preocular, extracranial pressure chamber, as well as a two-depth transorbital Doppler aimed at the intracranial and extracranial segment of the ophthalmic artery.…”

Section: Approaches Of Non-invasive Measurementsmentioning

confidence: 99%

Non-Invasive Intracranial Pressure Monitoring

Müller

Henkes

Gounis³

et al. 2023

JCM

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(1) Background: Intracranial pressure (ICP) monitoring plays a key role in the treatment of patients in intensive care units, as well as during long-term surgeries and interventions. The gold standard is invasive measurement and monitoring via ventricular drainage or a parenchymal probe. In recent decades, numerous methods for non-invasive measurement have been evaluated but none have become established in routine clinical practice. The aim of this study was to reflect on the current state of research and shed light on relevant techniques for future clinical application. (2) Methods: We performed a PubMed search for “non-invasive AND ICP AND (measurement OR monitoring)” and identified 306 results. On the basis of these search results, we conducted an in-depth source analysis to identify additional methods. Studies were analyzed for design, patient type (e.g., infants, adults, and shunt patients), statistical evaluation (correlation, accuracy, and reliability), number of included measurements, and statistical assessment of accuracy and reliability. (3) Results: MRI-ICP and two-depth Doppler showed the most potential (and were the most complex methods). Tympanic membrane temperature, diffuse correlation spectroscopy, natural resonance frequency, and retinal vein approaches were also promising. (4) Conclusions: To date, no convincing evidence supports the use of a particular method for non-invasive intracranial pressure measurement. However, many new approaches are under development.

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“…A follow-up study examined a group of 62 patients of various neurologic conditions (primarily idiopathic intracranial hypertension and multiple sclerosis) with invasively measured ICP by lumbar puncture and found a bias that was not statistically different from zero, with a standard deviation of error of 2.19 mm Hg, indicating a high level of precision [51]. Several other papers have seemingly confirmed a negligible bias in a variety of conditions [52,53]. Another paper investigated the classification efficacy of the TDTD technique by comparing it to the optic nerve sheath diameter (ONSD) method (described below) in a group of neurological patients (85 patients enrolled in TDTD and 92 in ONSD) requiring lumbar puncture and concluded that the TDTD method has better diagnostic reliability for detecting elevated ICP [54].…”

Section: Two-depth Ophthalmic Artery Doppler Ultrasonographymentioning

confidence: 99%

Review: pathophysiology of intracranial hypertension and noninvasive intracranial pressure monitoring

Canac

Jalaleddini

Thorpe

et al. 2020

Fluids Barriers CNS

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Measurement of intracranial pressure (ICP) is crucial in the management of many neurological conditions. However, due to the invasiveness, high cost, and required expertise of available ICP monitoring techniques, many patients who could benefit from ICP monitoring do not receive it. As a result, there has been a substantial effort to explore and develop novel noninvasive ICP monitoring techniques to improve the overall clinical care of patients who may be suffering from ICP disorders. This review attempts to summarize the general pathophysiology of ICP, discuss the importance and current state of ICP monitoring, and describe the many methods that have been proposed for noninvasive ICP monitoring. These noninvasive methods can be broken down into four major categories: fluid dynamic, otic, ophthalmic, and electrophysiologic. Each category is discussed in detail along with its associated techniques and their advantages, disadvantages, and reported accuracy. A particular emphasis in this review will be dedicated to methods based on the use of transcranial Doppler ultrasound. At present, it appears that the available noninvasive methods are either not sufficiently accurate, reliable, or robust enough for widespread clinical adoption or require additional independent validation. However, several methods appear promising and through additional study and clinical validation, could eventually make their way into clinical practice.

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Accuracy, Precision, Sensitivity, and Specificity of Noninvasive ICP Absolute Value Measurements

Cited by 12 publications

References 14 publications

A machine learning approach in the non-invasive prediction of intracranial pressure using Modified Photoplethysmography

A machine learning approach in the non-invasive prediction of intracranial pressure using Modified Photoplethysmography

Non-Invasive Intracranial Pressure Monitoring

Review: pathophysiology of intracranial hypertension and noninvasive intracranial pressure monitoring

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