Development and external validation of a stability machine learning model to identify wake-up stroke onset time from MRI.

Objectives: To develop and externally validate a machine learning (ML) model based on diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) to identify the onset time of wake-up stroke from MRI.Methods: DWI and FLAIR images of stroke patients within 24 h of clear symptom o...

Full description

Bibliographic Details
Published in:European Radiology Vol. 32; no. 6; pp. 3661 - 3670
Main Authors: Jiang, Liang, Wang, Siyu, Ai, Zhongping, Shen, Tingwen, Zhang, Hong, Duan, Shaofeng, Chen, Yu-Chen, Yin, Xindao, Sun, Jun
Format: Journal Article
Published: Springer Nature Jun2022
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=157006562&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 157006562
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        09387994
        NPH
      jtl: European Radiology
      issn: 09387994
      maglogo: N
    pubinfo:
      dt: Jun2022
      vid: 32
      iid: 6
      pid: 237
      pub: Springer Nature
      place: New York, New York
    artinfo:
      ui:
        157006562
        157006562
        NLM35037969
        10.1007/s00330-021-08493-6
        NLM35037969
        157006562
      ppf: 3661
      ppct: 9
      formats:
        fmt:
          – @attributes:
              type: T
          – @attributes:
              type: P
      tig:
        atl: Development and external validation of a stability machine learning model to identify wake-up stroke onset time from MRI.
      aug:
        au:
          Jiang, Liang
          Wang, Siyu
          Ai, Zhongping
          Shen, Tingwen
          Zhang, Hong
          Duan, Shaofeng
          Chen, Yu-Chen
          Yin, Xindao
          Sun, Jun
        affil: Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No. 68, Changle Road, 210006, Nanjing, China
      sug:
      ab: Objectives: To develop and externally validate a machine learning (ML) model based on diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) to identify the onset time of wake-up stroke from MRI.Methods: DWI and FLAIR images of stroke patients within 24 h of clear symptom onset in our hospital (dataset 1, n = 410) and another hospital (dataset 2, n = 177) were included. Seven ML models based on dataset 1 were developed to estimate the stroke onset time for binary classification (≤ 4.5 h or > 4.5 h): Random Forest (RF), support vector machine with kernel (svmLinear) or radial basis function kernel (svmRadial), Bayesian (Bayes), K-nearest neighbor (KNN), adaptive boosting (AdaBoost), and neural network (NNET). ROC analysis and RSD were performed to evaluate the performance and stability of the ML models, respectively, and dataset 2 was externally validated to evaluate the model generalization ability using ROC analysis.Results: svmRadial achieved the best performance with the highest AUC and accuracy (AUC: 0.896, accuracy: 0.878), and was the most stable (RSD% of AUC: 0.08, RSD% of accuracy: 0.06). The svmRadial model was then selected as the final model, and the AUC of the svmRadial model for predicting the onset time external validation was 0.895, with 0.825 accuracy.Conclusions: The svmRadial model using DWI + FLAIR is the most stable and generalizable for identifying the onset time of wake-up stroke patients within 4.5 h of symptom onset.Key Points: • Machining learning model helps clinicians to identify wake-up stroke patients within 4.5 h of symptom onset. • A prospective study showed that svmRadial model based on DWI + FLAIR was the most stable in predicting the stroke onset time. • External validation showed that svmRadial model has good generalization ability in predicting the stroke onset time.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N