Automated Assessment of Leptomeningeal Collaterals on CT Angiograms

CT 血管造影上软脑膜循环的自动评估

• 批准号: 9622038
• 负责人: STEPHEN R AYLWARD
• 金额: $ 49万
• 依托单位: KITWARE, INC.
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-06-01 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9622038
• 关键词: Academia; Acute; Address; Algorithms; Angiography; Blood Pressure; Blood Vessels; Blood flow; Brain; Characteristics; Clinic; Clinical; Clinical Research; Clinical Trials; Computer software; Data; Development; Diagnostic; Diffusion; Distal; Doctor of Medicine; Effectiveness; Evaluation; Feedback; Future; Goals; Gold; Hemorrhage; Hour; Human; Hypertension; Image; Industry; Infarction; Intervention; Intraobserver Variability; Intravenous; Ischemic Stroke; Link; Literature; Manuals; Measures; Methods; Modality; Odds Ratio; Online Systems; Outcome; Patient risk; Patient-Focused Outcomes; Patients; Pattern; Perfusion; Persons; Phase; Play; Privatization; Procedures; Process; Property; Protocols documentation; Radiology Specialty; Recurrence; Research; Risk; Role; Running; Security; Services; Site; Small Business Technology Transfer Research; Standardization; Stroke; System; Techniques; Testing; Thrombolytic Therapy; Tissues; Training; Treatment Efficacy; Trees; Triage; Visualization software; Work; X-Ray Computed Tomography; acute stroke; base; computer science; cost effective; deep learning; design; digital; experimental study; improved; innovation; open source; outcome prediction; post stroke; product development; prospective; prototype; research clinical testing; research study; statistics; stroke outcome; stroke patient; thrombolysis; tool; treatment arm; web services

Abstract The primary goal of this study is to develop an automated scoring system of leptomeningeal collaterals based on CT angiography (CTA) as a quantitative assessment of acute ischemic stroke. Leptomeningeal collaterals provide an alternate path of blood flow in the setting of a proximal vessel occlusion. The presence and effectiveness of leptomeningeal collaterals (i.e., “collateral status”) varies significantly from patient to patient. Collateral status has been shown to be correlated with both patient outcome and risk of hemorrhagic transformation, suggesting that rapid and accurate assessment of the collaterals would provide a powerful tool for treatment evaluation. The current gold standard for collateral scoring is performed by subjective analysis of retrograde filling in invasive digital subtraction angiograms (DSA). Though CTA is more limited than DSA in the direct evaluation of collaterals, the presence of collaterals may also be evaluated in CTA by the tree-pattern of vessel filling around the site of occlusion. Several manual assessment techniques based on CTA have been proposed in the literature, but all are subjective and require significant human intervention. During Phase I, we deployed a web-based system for automated assessment of stroke collaterals based on CTA, and we used it in a preliminary study of collateral status for stroke assessment. In this Phase II STTR proposal, the specific aims are (1) to improve the integration of our system with clinical workflows; (2) expand the system to also compute CT perfusion stroke measures, so as to provide a unified platform for comparing and combining CTA collateral and CT perfusion assessment metrics; and (3) test the hypotheses that the combined use of CTA collateral and CT perfusion measures outperforms either method independently for treatment efficacy prediction in stroke patients.

摘要 本研究的主要目的是开发一个软脑膜侧支循环的自动评分系统 基于CT血管造影（CTA）作为急性缺血性卒中的定量评估。软脑膜 在近端血管闭塞的情况下，侧支提供了血液流动的替代路径。存在 和软脑膜侧支的有效性（即，“侧支状态”）在不同患者之间存在显著差异， 病人已证明侧支状态与患者结局和出血性血管紧张素转换酶抑制剂的风险相关。 这表明，快速准确地评估抵押品将提供一个强大的工具， 用于治疗评估。目前的抵押品评分金标准是通过主观分析进行的， 逆行填充在有创数字减影血管造影（DSA）。虽然CTA在血管造影中比DSA更有局限性， 直接评估侧支循环，侧支循环的存在也可以在CTA中通过 闭塞部位周围的血管充盈。几种基于CTA的手动评估技术已经被 在文献中提出的，但都是主观的，需要大量的人为干预。 在第一阶段，我们部署了一个基于网络的系统，用于自动评估中风侧支循环， 在CTA上，我们将其用于中风评估侧支状态的初步研究。 在第二阶段短期信托计划建议中，具体目标是：（1）改善我们的系统与 临床工作流程;（2）扩展系统以计算CT灌注卒中测量，从而提供 用于比较和组合CTA侧支血管和CT灌注评估指标的统一平台;以及（3） 检验联合使用CTA侧支血管造影和CT灌注测量优于 方法独立用于中风患者的治疗效果预测。