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Research ArticleAdult Brain
Open Access

Radiomics-Based Intracranial Thrombus Features on CT and CTA Predict Recanalization with Intravenous Alteplase in Patients with Acute Ischemic Stroke

W. Qiu, H. Kuang, J. Nair, Z. Assis, M. Najm, C. McDougall, B. McDougall, K. Chung, A.T. Wilson, M. Goyal, M.D. Hill, A.M. Demchuk and B.K. Menon
American Journal of Neuroradiology January 2019, 40 (1) 39-44; DOI: https://doi.org/10.3174/ajnr.A5918
W. Qiu
aFrom the Departments of Clinical Neurosciences (W.Q., H.K., J.N., Z.A. M.N., C.M., A.T.W., B.M., M.G., M.D.H., A.M.D., B.K.M.)
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H. Kuang
aFrom the Departments of Clinical Neurosciences (W.Q., H.K., J.N., Z.A. M.N., C.M., A.T.W., B.M., M.G., M.D.H., A.M.D., B.K.M.)
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J. Nair
aFrom the Departments of Clinical Neurosciences (W.Q., H.K., J.N., Z.A. M.N., C.M., A.T.W., B.M., M.G., M.D.H., A.M.D., B.K.M.)
fDepartment of Radiology (J.N.), McMaster University, Hamilton, Ontario, Canada.
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Z. Assis
aFrom the Departments of Clinical Neurosciences (W.Q., H.K., J.N., Z.A. M.N., C.M., A.T.W., B.M., M.G., M.D.H., A.M.D., B.K.M.)
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M. Najm
aFrom the Departments of Clinical Neurosciences (W.Q., H.K., J.N., Z.A. M.N., C.M., A.T.W., B.M., M.G., M.D.H., A.M.D., B.K.M.)
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C. McDougall
aFrom the Departments of Clinical Neurosciences (W.Q., H.K., J.N., Z.A. M.N., C.M., A.T.W., B.M., M.G., M.D.H., A.M.D., B.K.M.)
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B. McDougall
aFrom the Departments of Clinical Neurosciences (W.Q., H.K., J.N., Z.A. M.N., C.M., A.T.W., B.M., M.G., M.D.H., A.M.D., B.K.M.)
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K. Chung
bCalgary Stroke Program, Mechanical and Manufacturing Engineering (K.C.)
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A.T. Wilson
aFrom the Departments of Clinical Neurosciences (W.Q., H.K., J.N., Z.A. M.N., C.M., A.T.W., B.M., M.G., M.D.H., A.M.D., B.K.M.)
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M. Goyal
aFrom the Departments of Clinical Neurosciences (W.Q., H.K., J.N., Z.A. M.N., C.M., A.T.W., B.M., M.G., M.D.H., A.M.D., B.K.M.)
cRadiology (M.D.H., A.M.D., M.G., B.K.M.)
eHotchkiss Brain Institute (M.D.H., A.M.D., M.G., B.K.M.), Calgary, Alberta, Canada
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M.D. Hill
aFrom the Departments of Clinical Neurosciences (W.Q., H.K., J.N., Z.A. M.N., C.M., A.T.W., B.M., M.G., M.D.H., A.M.D., B.K.M.)
cRadiology (M.D.H., A.M.D., M.G., B.K.M.)
dCommunity Health Sciences (M.D.H., B.K.M.), University of Calgary, Calgary, Alberta, Canada
eHotchkiss Brain Institute (M.D.H., A.M.D., M.G., B.K.M.), Calgary, Alberta, Canada
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A.M. Demchuk
aFrom the Departments of Clinical Neurosciences (W.Q., H.K., J.N., Z.A. M.N., C.M., A.T.W., B.M., M.G., M.D.H., A.M.D., B.K.M.)
cRadiology (M.D.H., A.M.D., M.G., B.K.M.)
eHotchkiss Brain Institute (M.D.H., A.M.D., M.G., B.K.M.), Calgary, Alberta, Canada
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B.K. Menon
aFrom the Departments of Clinical Neurosciences (W.Q., H.K., J.N., Z.A. M.N., C.M., A.T.W., B.M., M.G., M.D.H., A.M.D., B.K.M.)
cRadiology (M.D.H., A.M.D., M.G., B.K.M.)
dCommunity Health Sciences (M.D.H., B.K.M.), University of Calgary, Calgary, Alberta, Canada
eHotchkiss Brain Institute (M.D.H., A.M.D., M.G., B.K.M.), Calgary, Alberta, Canada
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    Fig 1.

    Visualized feature images of thrombus of 2 patients, one with early recanalization and another without recanalization. The selected feature, Laws SD of LSW, is demonstrated. The LSW value (gray-level) of each pixel in the feature map is measuring the heterogeneity in the local region of each pixel.

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    Fig 2.

    ROC results of the best radiomics features from different feature groups, compared with clinically relevant currently measurable features such as thrombus length, volume, and permeability measurements, as well as subjective assessment of the residual flow grade. The numbers in the parentheses following legend names denote AUC values and ranking after linear discriminative analysis.

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    Fig 3.

    ROC curves for the prediction of early recanalization with IV alteplase using 67 patients (30 patients versus 37 controls). The bars on the curves represent the SDs of 10 repetitions. A, ROC curves for each feature group. B, ROC curves for different combinations of feature groups.

Tables

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  • Radiomics features used in the analysis

    MethodNo. of Features
    Set 1: First-order statisticsVoxel intensity distribution34
    Set 2: Shape and sizeThrombus length, surface, and volume6
    Set 3: Textural featuresGray-level co-occurrence matrix78
    Gray-level run length matrix66
    Neighborhood gray-level difference matrix10
    Law texture105
    Local binary pattern27
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American Journal of Neuroradiology: 40 (1)
American Journal of Neuroradiology
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W. Qiu, H. Kuang, J. Nair, Z. Assis, M. Najm, C. McDougall, B. McDougall, K. Chung, A.T. Wilson, M. Goyal, M.D. Hill, A.M. Demchuk, B.K. Menon
Radiomics-Based Intracranial Thrombus Features on CT and CTA Predict Recanalization with Intravenous Alteplase in Patients with Acute Ischemic Stroke
American Journal of Neuroradiology Jan 2019, 40 (1) 39-44; DOI: 10.3174/ajnr.A5918

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Radiomics-Based Intracranial Thrombus Features on CT and CTA Predict Recanalization with Intravenous Alteplase in Patients with Acute Ischemic Stroke
W. Qiu, H. Kuang, J. Nair, Z. Assis, M. Najm, C. McDougall, B. McDougall, K. Chung, A.T. Wilson, M. Goyal, M.D. Hill, A.M. Demchuk, B.K. Menon
American Journal of Neuroradiology Jan 2019, 40 (1) 39-44; DOI: 10.3174/ajnr.A5918
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  • A Deep Learning Approach to Predict Recanalization First-Pass Effect following Mechanical Thrombectomy in Patients with Acute Ischemic Stroke
  • Response to Letter Regarding the Article "Automated Segmentation of Intracranial Thrombus on NCCT and CTA in Patients with Acute Ischemic Stroke Using a Coarse-to-Fine Deep Learning Model"
  • Multimodal CT imaging of ischemic stroke thrombi identifies scale-invariant radiomic features that reflect clot biology
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  • Thrombus radiomics in patients with anterior circulation acute ischemic stroke undergoing endovascular treatment
  • Automated Segmentation of Intracranial Thrombus on NCCT and CTA in Patients with Acute Ischemic Stroke Using a Coarse-to-Fine Deep Learning Model
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