Association of Automatically Quantified Total Blood Volume after Aneurysmal Subarachnoid Hemorrhage with Delayed Cerebral Ischemia

Zijlstra, Ijsbrand A.J.; Gathier, Celine S.; Boers, Anna M. M.; Marquering, Henk A.; Slooter, Arjen J. C.; Velthuis, Birgitta K.; Coert, Bert A.; Verbaan, Dagmar; Berg, René van den; Rinkel, Gabriël J.E.; Majoie, Charles B. L. M.

doi:10.3174/ajnr.a4771

Cited by 28 publications

(30 citation statements)

References 17 publications

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“…Thus, the possibility that the Hijdra score has a higher association to DCI as the Fisher and modified Fisher score cannot be ruled out. Recently, new radiological scales like the Barrow Neurological Institute SAH Grading Scale, incorporation of the Modified Graeb score to the modified Fisher, and quantification of SAH volume have been introduced [67,[68][69][70][71]. These scales measure the amount of blood in a more quantitative manner and have shown high associations with DCI and reduced interobserver variability.…”

Section: Discussionmentioning

confidence: 99%

Radiological scales predicting delayed cerebral ischemia in subarachnoid hemorrhage: systematic review and meta-analysis

et al. 2019

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Purpose Delayed cerebral ischemia (DCI) is a severe complication of aneurysmal subarachnoid hemorrhage (aSAH). The extent of subarachnoid blood is a strong predictor of DCI and is frequently estimated with the Fisher scale, modified Fisher scale, or Hijdra sum score. It is unclear which scale has the strongest association with clinical DCI. To evaluate this, we performed a systematic review of the literature. Methods We performed a MEDLINE and EMBASE search from 1980 to 20th of June 2017. Radiological grade and occurrence of clinical DCI were extracted along with odds ratios (ORs) for DCI. When possible, pooled ORs with 95% confidence intervals were calculated per grade increase on the radiological scale.Results Fifty-three studies were included. The Fisher scale was significantly associated with DCI in 62% of the studies compared to 88-100% for the other scales. In studies using the Fisher scale, Fisher 3 had the strongest association with DCI (pooled OR 3.21 (1.87-5.49)). In studies using the modified Fisher score, DCI occurred most frequently (42%) in modified Fisher 4. No pooled OR could be calculated for the other scales. Conclusion The Fisher scale, modified Fisher scale, and Hijdra sum score are all associated with clinical DCI. The risk of DCI, however, does not increase with increasing Fisher grade as opposed to the modified Fisher scale. Furthermore, the modified Fisher scale was more commonly significantly associated with DCI than the Fisher scale, which may advocate using the modified Fisher in future SAH-related studies.

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Section: Discussionmentioning

confidence: 99%

Radiological scales predicting delayed cerebral ischemia in subarachnoid hemorrhage: systematic review and meta-analysis

et al. 2019

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“…Some image-derived features that are well known for being associated with DCI are the TBV and the blood location 3. The manual extraction of features from medical images is a time-consuming task and these features might not be the only important ones available in the images 21…”

Section: Methodsmentioning

confidence: 99%

“…The dataset is randomly split into training (75%) and testing (25%) set to prevent overoptimistic results. Model 1 included the following variables: WFNS, age, aneurysm treatment (clipping or coiling), intraparenchymal and intraventricular hemorrhage and TBV 3. Model 2 included the following variables: hypertension, diabetes mellitus, history of smoking, alcohol use, hyperglycemia and Hunt and Hess grade on admission 4…”

Section: Methodsmentioning

confidence: 99%

“…Several studies have identified risk factors associated with the development of DCI, including World Federation of Neurosurgical Societies (WFNS) grade, age, aneurysm treatment (clipping or coiling), intraparenchymal and intraventricular hemorrhage, total blood volume (TBV),3 hypertension, diabetes mellitus, history of smoking, alcohol use, hyperglycemia and Hunt and Hess grade on admission 4…”

Section: Introductionmentioning

confidence: 99%

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Machine learning improves prediction of delayed cerebral ischemia in patients with subarachnoid hemorrhage

Ramos

Steen

Barros

et al. 2018

J NeuroIntervent Surg

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Background and purposeDelayed cerebral ischemia (DCI) is a severe complication in patients with aneurysmal subarachnoid hemorrhage. Several associated predictors have been previously identified. However, their predictive value is generally low. We hypothesize that Machine Learning (ML) algorithms for the prediction of DCI using a combination of clinical and image data lead to higher predictive accuracy than previously applied logistic regressions.Materials and methodsClinical and baseline CT image data from 317 patients with aneurysmal subarachnoid hemorrhage were included. Three types of analysis were performed to predict DCI. First, the prognostic value of known predictors was assessed with logistic regression models. Second, ML models were created using all clinical variables. Third, image features were extracted from the CT images using an auto-encoder and combined with clinical data to create ML models. Accuracy was evaluated based on the area under the curve (AUC), sensitivity and specificity with 95% CI.ResultsThe best AUC of the logistic regression models for known predictors was 0.63 (95% CI 0.62 to 0.63). For the ML algorithms with clinical data there was a small but statistically significant improvement in the AUC to 0.68 (95% CI 0.65 to 0.69). Notably, aneurysm width and height were included in many of the ML models. The AUC was highest for ML models that also included image features: 0.74 (95% CI 0.72 to 0.75).ConclusionML algorithms significantly improve the prediction of DCI in patients with aneurysmal subarachnoid hemorrhage, particularly when image features are also included. Our experiments suggest that aneurysm characteristics are also associated with the development of DCI.

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“…Previous studies have found a strong relation between the quantified amount of total blood volume and DCI. 9,21 However, in these studies, the volumes of blood in the separate compartments of the brain were not analyzed separately. It is therefore currently unknown whether taking the blood volumes at these locations into account improves the prediction of DCI.…”

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confidence: 99%

Association of Quantified Location-Specific Blood Volumes with Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage

Steen

Zijlstra²,

Verbaan³

et al. 2018

AJNR Am J Neuroradiol

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Association of Automatically Quantified Total Blood Volume after Aneurysmal Subarachnoid Hemorrhage with Delayed Cerebral Ischemia

Cited by 28 publications

References 17 publications

Radiological scales predicting delayed cerebral ischemia in subarachnoid hemorrhage: systematic review and meta-analysis

Radiological scales predicting delayed cerebral ischemia in subarachnoid hemorrhage: systematic review and meta-analysis

Machine learning improves prediction of delayed cerebral ischemia in patients with subarachnoid hemorrhage

Association of Quantified Location-Specific Blood Volumes with Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage

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