Prediction of pulmonary pressure after Glenn shunts by computed tomography-based machine learning models.

Objectives: This study aimed to develop non-invasive machine learning classifiers for predicting post-Glenn shunt patients with low and high risks of a mean pulmonary arterial pressure (mPAP) > 15 mmHg based on preoperative cardiac computed tomography (CT).Methods: This retrospective study included...

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Published in:European Radiology Vol. 30; no. 3; pp. 1369 - 1378
Main Authors: Huang, Lei, Li, Jiahua, Huang, Meiping, Zhuang, Jian, Yuan, Haiyun, Jia, Qianjun, Zeng, Dewen, Que, Lifeng, Xi, Yue, Lin, Jijin, Dong, Yuhao
Format: diagnostic images research tables/charts Journal Article
Published: Springer Nature 2020
Online Access:View this record in EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Prediction of pulmonary pressure after Glenn shunts by computed tomography-based machine learning models.
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        au:
          Huang, Lei
          Li, Jiahua
          Huang, Meiping
          Zhuang, Jian
          Yuan, Haiyun
          Jia, Qianjun
          Zeng, Dewen
          Que, Lifeng
          Xi, Yue
          Lin, Jijin
          Dong, Yuhao
        affil: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510080, Guangzhou, People's Republic of China
      sug:
        subj:
          Pulmonary Artery
          Cardiopulmonary Bypass
          Blood Pressure
          Heart Defects, Congenital Surgery
          Heart Defects, Congenital
          Heart Septal Defects Surgery
          Male
          Child
          Heart Catheterization
          Transposition of Great Arteries
          Discriminant Analysis
          Pulmonary Atresia
          Transposition of Great Arteries Surgery
          Pulmonary Atresia Surgery
          Retrospective Design
          Infant
          Young Adult
          Probability
          Child, Preschool
          Heart Septal Defects
          Lung
          Logistic Regression
          Prognosis
          Female
          Tricuspid Atresia
          Tricuspid Atresia Surgery
          Tomography, X-Ray Computed Methods
          Algorithms
          Adolescence
          Human
          Child: 6-12 years
          Infant: 1-23 months
          Child, Preschool: 2-5 years
          Adolescent: 13-18 years
          Male
          Female
      ab: Objectives: This study aimed to develop non-invasive machine learning classifiers for predicting post-Glenn shunt patients with low and high risks of a mean pulmonary arterial pressure (mPAP) > 15 mmHg based on preoperative cardiac computed tomography (CT).Methods: This retrospective study included 96 patients with functional single ventricle who underwent a bidirectional Glenn procedure between November 1, 2009, and July, 31, 2017. All patients underwent post-procedure CT, followed by cardiac catheterization. Overall, 23 morphologic parameters were manually extracted from cardiac CT images for each patient. The Mann-Whitney U or chi-square test was applied to select the most significant predictors. Six machine learning algorithms including logistic regression, Naive Bayes, random forest (RF), linear discriminant analysis, support vector machine, and K-nearest neighbor were used for modeling. These algorithms were independently trained on 100 train-validation random splits with a 3:1 ratio. Their average performance was evaluated by area under the curve (AUC), accuracy, sensitivity, and specificity.Results: Seven CT morphologic parameters were selected for modeling. RF obtained the best performance, with mean AUC of 0.840 (confidence interval [CI] 0.832-0.850) and 0.787 (95% CI 0.780-0.794); sensitivity of 0.815 (95% CI 0.797-0.833) and 0.778 (95% CI 0.767-0.788), specificity of 0.766 (95% CI 0.748-0.785) and 0.746 (95% CI 0.735-0.757); and accuracy of 0.782 (95% CI 0.771-0.793) and 0.756 (95% CI 0.748-0.764) in the training and validation cohorts, respectively.Conclusions: The CT-based RF model demonstrates a good performance in the prediction of mPAP, which may reduce the need for right heart catheterization in post-Glenn shunt patients with suspected mPAP > 15 mmHg.Key Points: • Twenty-three candidate descriptors were manually extracted from cardiac computed tomography images, and seven of them were selected for subsequent modeling. • The random forest model presents the best predictive performance for pulmonary pressure among all methods. • The computed tomography-based machine learning model could predict post-Glenn shunt pulmonary pressure non-invasively.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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