Abstract WP52: Impact of Baseline DWI ASPECTS Lesion Topology on Functional Outcome after Endovascular Treatment
Bibliographic record
Abstract
Introduction: Acute brain infarction (BI) topology determined by diffusion weighted imaging - Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) on post-treatment magnetic resonance imaging (MRI) has been associated with clinical outcome in internal carotid artery (ICA) or proximal middle cerebral artery (MCA) occlusion treated by endovascular reperfusion therapy (EVRT). Hypothesis: We hypothesize that among the same type of patients, the topology of acute BI captured by DWI ASPECTS on baseline MRI may be associated with 3 months functional outcome after EVRT. Methods: Consecutive patients with an acute BI complicating ICA or proximal MCA occlusion treated by EVRT after a baseline MRI before treatment at a single center between April 2007 and March 2013 were enrolled. Poor functional outcome was defined by modified Rankin Scale (mRS) of 3 to 6 at 3 months. We used penalized logistic regression due to the multicollinearity between DWI-ASPECTS sites to assess the relationship between each DWI-ASPECTS sites and functional outcome after adjustment for age, sex, blood pressure, DWI lesion volume and infarct side. We estimated this relationship in the full cohort of patients and according to the achievement of a complete recanalization. Results: We enrolled 206 patients [mean age 71 ± 16.5, median NIHSS 16 (IQR 10-21)]. Among them 58 (28%) had an ICA occlusion, 115 (56%) a MCA M1 occlusion and 33 (16%) a MCA M2 occlusion. Median DWI lesion volume was 13 mL (IQR 4-43), and median DWI ASPECTS score was 6 (IQR 4-8). A complete recanalization was achieved among 96 patients (47%), after a median time from onset of 237 min (IQR:185-282). The involvement of the lentiform nucleus was associated with poor functional outcome in the full cohort of patients [OR : 10; 95% CI (5-23); p<0.0001]. This relationship was observed in the subgroup of patients who did experience a complete recanalization [OR : 4; 95% CI (1.5-12); p=0.007] and among those who did not [OR : 21; 95% CI (5-92); p<0.0001]. Conclusions: In conclusion, the involvement of the DWI ASPECTS lentiform region on baseline MRI in patients experiencing an acute BI complicating an ICA or MCA occlusion treated by EVRT was associated with poor functional outcome, overall and despite a complete recanalization.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".