Deep Learning-Based Automated Thrombolysis in Cerebral Infarction Scoring: A Timely Proof-of-Principle Study.

Journal: Stroke
Published Date:

Abstract

BACKGROUND AND PURPOSE: Mechanical thrombectomy is an established procedure for treatment of acute ischemic stroke. Mechanical thrombectomy success is commonly assessed by the Thrombolysis in Cerebral Infarction (TICI) score, assigned by visual inspection of X-ray digital subtraction angiography data. However, expert-based TICI scoring is highly observer-dependent. This represents a major obstacle for mechanical thrombectomy outcome comparison in, for instance, multicentric clinical studies. Focusing on occlusions of the M1 segment of the middle cerebral artery, the present study aimed to develop a deep learning (DL) solution to automated and, therefore, objective TICI scoring, to evaluate the agreement of DL- and expert-based scoring, and to compare corresponding numbers to published scoring variability of clinical experts.

Authors

  • Maximilian Nielsen
    Department of Computational Neuroscience (M.N., T.S., R.W.), University Medical Center-Hamburg-Eppendorf, Germany.
  • Moritz Waldmann
    Department of Diagnostic and Interventional Neuroradiology (M.W., A.M.F., F.F., J.F.), University Medical Center-Hamburg-Eppendorf, Germany.
  • Andreas M Frölich
    Department of Diagnostic and Interventional Neuroradiology (M.W., A.M.F., F.F., J.F.), University Medical Center-Hamburg-Eppendorf, Germany.
  • Fabian Flottmann
    Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Evelin Hristova
    Eppdata GmbH, Hamburg, Germany (E.H.).
  • Martin Bendszus
    Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
  • Fatih Seker
    Department of Neuroradiology, Heidelberg University Hospital, Germany (M.B., F.S.).
  • Jens Fiehler
    Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Thilo Sentker
  • Rene Werner