Abstract 161: Prediction of Thrombolysis-induced Parenchymal Hemorrhage in Patients With Acute Ischemic Stroke: Use of MR Perfusion and Diffusion Biomarkers
Bibliographic record
Abstract
Purpose: Ischemic stroke patients with low cerebral blood volume (CBV), low apparent diffusion coefficient (ADC) and increased microvascular permeability (K2) have increased risk of parenchymal hemorrhage (PH) after recanalization therapies. We have developed a predictive model to examine the risk of PH following revascularization therapies using combined MR perfusion and diffusion biomarkers. Methods: Voxel-based values of rCBV, K2, and ADC from the infarction core were obtained using pre-treatment MRI data from patients enrolled in the Mechanical Retrieval and Recanalization of Stroke Clots Using Embolectomy (MR RESCUE) clinical trial. Using histogram analyses the 10 th and 90 th percentile values were calculated for the rCBV, ADC, and K2 variables for each patient. The associations between PH and extreme values of CBV (10%rCBV), ADC (10%ADC), and K2 (90%K2) in each patient were assessed in univariate and multivariate analyses. Receiver operating characteristic (ROC) analysis was performed to determine the optimal parameter/s and threshold for predicting PH. Results: In 83 patients included in this analysis, 20 (24%, 13 PH1, 7 PH2) developed PH. Univariate analysis showed significantly lower 10%rCBV and 10%ADC values and significantly higher 90%K2 values in patients with PH. After controlling for age, baseline NIHSS, infarct volume, and status of recanalization, multivariate logistic regression analysis identified 10%rCBV (p=0.002) and 90%K2 (p=0.03), but not 10%ADC (p=0.07), as independent predictors of PH. For 10%RCBV, ROC analysis showed the greatest AUC (0.87) at a threshold < 0.45 with sensitivity/specificity of 95%70%. For 90%K2, the greatest AUC (0.75) was obtained at a threshold of > 0.27 with sensitivity/specificity of 90%/60%. In a separate model, a combined K2-rCBV classifier remained the single independent predictor of PH (OR=33). Conclusion: Our results suggest that combined increased permeability and decreased rCBV derived from MR perfusion can be used for risk stratification in patients with AIS before undergoing revascularization therapies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".