A clinical–radiomics model based on noncontrast computed tomography to predict hemorrhagic transformation after stroke by machine learning: a multicenter study

作者：Huanhuan Ren, Haojie Song, Jingjie Wang, Hua Xiong, Bangyuan Long, Meilin Gong, Jiayang Liu, Zhanping He, Li Liu, Xili Jiang, Lifeng Li, Hanjian Li, Shaoguo Cui, Yongmei Li · 发表于：Insights into Imaging · 年份：2023 · DOI：10.1186/s13244-023-01399-5 · 被引用次数：34 · 研究领域：Acute Ischemic Stroke Management、Radiomics and Machine Learning in Medical Imaging、Artificial Intelligence in Healthcare and Education

OBJECTIVE: To build a clinical-radiomics model based on noncontrast computed tomography images to identify the risk of hemorrhagic transformation (HT) in patients with acute ischemic stroke (AIS) following intravenous thrombolysis (IVT). MATERIALS AND METHODS: A total of 517 consecutive patients with AIS were screened for inclusion. Datasets from six hospitals were randomly divided into a training cohort and an internal cohort with an 8:2 ratio. The dataset of the seventh hospital was used for an independent external verification. The best dimensionality reduction method to choose features and the best machine learning (ML) algorithm to develop a model were selected. Then, the clinical, radiomics and clinical-radiomics models were developed. Finally, the performance of the models was measured using the area under the receiver operating characteristic curve (AUC). RESULTS: Of 517 from seven hospitals, 249 (48%) had HT. The best method for choosing features was recursive feature elimination, and the best ML algorithm to build models was extreme gradient boosting. In distinguishing patients with HT, the AUC of the clinical model was 0.898 (95% CI 0.873-0.921) in the internal validation cohort, and 0.911 (95% CI 0.891-0.928) in the external validation cohort; the AUC of radiomics model was 0.922 (95% CI 0.896-0.941) and 0.883 (95% CI 0.851-0.902), while the AUC of clinical-radiomics model was 0.950 (95% CI 0.925-0.967) and 0.942 (95% CI 0.927-0.958) respectively. CONCLUSION: The ...