Automated Measurement of Cerebral Atrophy and Outcome in Endovascular Thrombectomy

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dc.contributor.author Diprose, William en
dc.contributor.author Diprose, JP en
dc.contributor.author Wang, Michael en
dc.contributor.author Tarr, Gregory en
dc.contributor.author McFetridge, A en
dc.contributor.author Barber, Peter en
dc.date.accessioned 2019-10-29T00:14:52Z en
dc.date.issued 2019-09-27 en
dc.identifier.issn 1524-4628 en
dc.identifier.uri http://hdl.handle.net/2292/48667 en
dc.description.abstract Background and Purpose— Methods of identifying ischemic stroke patients with a greater probability of poor outcome following endovascular thrombectomy (EVT) might improve shared treatment decision-making between patients, families, and physicians. We used an objective, automated method to measure cerebral atrophy and investigated whether this was associated with outcome in EVT patients. Methods— Consecutive EVT patients from a single-center registry were studied. CT brain scans were segmented with a combination of a validated U-Net and Hounsfield unit thresholding. Intracranial cerebrospinal fluid (CSF) volume was used as a marker of cerebral atrophy and calculated as a proportion of total intracranial volume. The primary outcome was functional independence, defined as a 3-month modified Rankin Scale score of 0 to 2. Results— Three-hundred sixty EVT patients were included. Functional independence was achieved in 204 (56.7%) patients. The mean±SD CSF volume was 9.0±4.7% of total intracranial volume. Multivariable regression demonstrated that increasing CSF volume was associated with reduced functional independence (OR=0.65 per 5% increase in CSF volume; 95% CI, 0.48–0.89; P=0.007) and higher 3-month modified Rankin Scale scores (common OR, 1.59 per 5% increase in CSF volume; 95% CI, 1.05–2.41; P=0.03). Conclusions— Cerebral atrophy determined by automated measurement of intracranial CSF volume is associated with functional outcome in patients undergoing EVT. If validated in future studies, this simple, objective, and automated imaging marker could potentially be incorporated into decision-support tools to improve shared treatment decision-making. en
dc.publisher American Heart Association en
dc.relation.ispartofseries Stroke en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title Automated Measurement of Cerebral Atrophy and Outcome in Endovascular Thrombectomy en
dc.type Journal Article en
dc.identifier.doi 10.1161/STROKEAHA.119.027120 en
dc.rights.holder Copyright: The author en
pubs.author-url https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.027120 en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 783032 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Medicine Department en
pubs.org-id Ophthalmology Department en
pubs.org-id Surgery Department en
pubs.record-created-at-source-date 2019-09-28 en
pubs.dimensions-id 31558139 en


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