The value of radiomics-based hyperdense middle cerebral artery sign in predicting hemorrhagic transformation in acute ischemic stroke patients undergoing endovascular treatment
Bibliographic record
Abstract
Objective: To establish and validate a model based on hyperdense middle cerebral artery sign (HMCAS) radiomics features for predicting hemorrhagic transformation (HT) in patients with acute ischemic stroke (AIS) after endovascular treatment (EVT). Methods: Patients with AIS who presented with HMCAS on non-contrast computed tomography (NCCT) at admission and underwent EVT at three comprehensive hospitals between June 2020 and January 2024 were recruited for this retrospective study. A radiomics model was constructed using the HMCAS radiomics features most strongly associated with HT. In addition, clinical and radiological independent factors associated with HT were identified. Subsequently, a combined model incorporating radiomics features and independent risk factors was developed via multivariate logistic regression and presented as a nomogram. The models were evaluated via receiver operating characteristic curve, calibration curve, and decision curve analysis. Results: Of the 118 patients, 71 (60.17%) developed HT. The area under the curve (AUC) of the radiomics model was 0.873 (95% CI 0.797-0.935) in the training cohort and 0.851 (95%CI 0.721-0.942) in the test cohort. The Alberta Stroke Program Early CT score (ASPECTS) was the only independent predictor among 24 clinical and 4 radiological variables. The combined model further improved the predictive performance, with an AUC of 0.911 (95%CI 0.850-0.960) in the training cohort and 0.877 (95%CI 0.753-0.960) in the test cohort. Decision curve analysis demonstrated that the combined model had greater clinical utility for predicting HT. Conclusion: HMCAS-based radiomics is expected to be a reliable tool for predicting HT risk stratification in AIS patients after EVT.
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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 | 0.004 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
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".