Prediction of Stroke Outcome from Early MRI Data using an Adaptive Neural Network

描述（由申请人提供）：我们以前使用联合MRI图像集和迭代自组织数据分析（ISODATA）来获得脑卒中动物模型和人类最终病变体积的时间无关预测。最近，我们通过引入自适应神经网络（ANN）作为3个月时t2加权图像的预测器，对这种方法进行了改进和改进，从而提供了组织结果的基本连续描述符，而不是ISODATA中产生的更粗糙的分类方案。在这项R03申请中，我们建议将该方法应用于对中风项目资助的人类部分在过去十年中获得的现有人类研究数据集的重新分析，从而提供中风结果的早期和可靠预测。外部笔画数据库将用作独立的验证集。最后，将对抗血小板药物阿昔单抗的开放标签试验和盲法试验中的MRI变化进行检查。后一项检查将允许对人工神经网络预测器的操作特征的描述（即，其与临床测量的联系）进行改进。如果这项工作取得成功，我们将生产一种替代MRI结果测量方法，该方法将快速可用（本质上是实时的）来预测中风急性和亚急性期脑实质的最终结果。这将允许对急性和亚急性中风患者的治疗效果进行实时评估。

DESCRIPTION (provided by applicant): We have previously used combined MRI image sets and iterative self-organizing data analysis (ISODATA), to obtain a time-independent prediction of eventual lesion volume in animal models of stroke and in humans. Recently, we have refined and improved this approach by introducing an adaptive neural network (ANN) as a predictor of the T2-weighted image at 3 months, thus providing an essentially continuous descriptor of tissue outcome, rather than the much coarser classification scheme produced in ISODATA. In this R03 application, we propose to apply this methodology to the reanalysis of an existing data set of human studies obtained over a period of ten years by the human arm of a stroke program project grant, and thereby provide an early and robust predictor of outcome in stroke. An external stroke data base will be used as an independent validating set. Finally, an examination of MRI changes in an open-label trial, and in a blinded trial, of the anti-platelet drug abciximab will be conducted. This latter examination will allow the description of the operating characteristics of the ANN predictor (i.e., its connection to clinical measures) to be refined. If this effort is successful, we will produce a surrogate MRI outcome measure that will be quickly available (essentially in real time) to predict the final results of stroke in the parenchyma of the brain, at the acute and subacute stages of stroke. This will allow the real-time assessment of treatment effects in acute and subacute stroke patients. PUBLIC HEALTH RELEVANCE: Stroke is a leading cause of death and disability in the United States. Using MRI images taken in the early stages of stroke, we aim to produce a predictor of stroke outcome so that therapeutic interventions can be assessed in real-time. PHS 398/2590 (Rev. 09/04, Reissued 4/2006) 1 Continuation Format Page