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Browsing by Author "Yeom, Kristen W."
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Item DEEP MOVEMENT: Deep learning of movie files for management of endovascular thrombectomy(Springer, 2023) Kelly, Brendan; Martinez, Mesha; Do, Huy; Hayden, Joel; Huang, Yuhao; Yedavalli, Vivek; Ho, Chang; Keane, Pearse A.; Killeen, Ronan; Lawlor, Aonghus; Moseley, Michael E.; Yeom, Kristen W.; Lee, Edward H.; Radiology and Imaging Sciences, School of MedicineObjectives: Treatment and outcomes of acute stroke have been revolutionised by mechanical thrombectomy. Deep learning has shown great promise in diagnostics but applications in video and interventional radiology lag behind. We aimed to develop a model that takes as input digital subtraction angiography (DSA) videos and classifies the video according to (1) the presence of large vessel occlusion (LVO), (2) the location of the occlusion, and (3) the efficacy of reperfusion. Methods: All patients who underwent DSA for anterior circulation acute ischaemic stroke between 2012 and 2019 were included. Consecutive normal studies were included to balance classes. An external validation (EV) dataset was collected from another institution. The trained model was also used on DSA videos post mechanical thrombectomy to assess thrombectomy efficacy. Results: In total, 1024 videos comprising 287 patients were included (44 for EV). Occlusion identification was achieved with 100% sensitivity and 91.67% specificity (EV 91.30% and 81.82%). Accuracy of location classification was 71% for ICA, 84% for M1, and 78% for M2 occlusions (EV 73, 25, and 50%). For post-thrombectomy DSA (n = 194), the model identified successful reperfusion with 100%, 88%, and 35% for ICA, M1, and M2 occlusion (EV 89, 88, and 60%). The model could also perform classification of post-intervention videos as mTICI < 3 with an AUC of 0.71. Conclusions: Our model can successfully identify normal DSA studies from those with LVO and classify thrombectomy outcome and solve a clinical radiology problem with two temporal elements (dynamic video and pre and post intervention).Item MRI-based radiomics for prognosis of pediatric diffuse intrinsic pontine glioma: an international study(Oxford University Press, 2021-03-05) Tam, Lydia T.; Yeom, Kristen W.; Wright, Jason N.; Jaju, Alok; Radmanesh, Alireza; Han, Michelle; Toescu, Sebastian; Maleki, Maryam; Chen, Eric; Campion, Andrew; Lai, Hollie A.; Eghbal, Azam A.; Oztekin, Ozgur; Mankad, Kshitij; Hargrave, Darren; Jacques, Thomas S.; Goetti, Robert; Lober, Robert M.; Cheshier, Samuel H.; Napel, Sandy; Said, Mourad; Aquilina, Kristian; Ho, Chang Y.; Monje, Michelle; Vitanza, Nicholas A.; Mattonen, Sarah A.; Radiology and Imaging Sciences, School of MedicineBackground: Diffuse intrinsic pontine gliomas (DIPGs) are lethal pediatric brain tumors. Presently, MRI is the mainstay of disease diagnosis and surveillance. We identify clinically significant computational features from MRI and create a prognostic machine learning model. Methods: We isolated tumor volumes of T1-post-contrast (T1) and T2-weighted (T2) MRIs from 177 treatment-naïve DIPG patients from an international cohort for model training and testing. The Quantitative Image Feature Pipeline and PyRadiomics was used for feature extraction. Ten-fold cross-validation of least absolute shrinkage and selection operator Cox regression selected optimal features to predict overall survival in the training dataset and tested in the independent testing dataset. We analyzed model performance using clinical variables (age at diagnosis and sex) only, radiomics only, and radiomics plus clinical variables. Results: All selected features were intensity and texture-based on the wavelet-filtered images (3 T1 gray-level co-occurrence matrix (GLCM) texture features, T2 GLCM texture feature, and T2 first-order mean). This multivariable Cox model demonstrated a concordance of 0.68 (95% CI: 0.61-0.74) in the training dataset, significantly outperforming the clinical-only model (C = 0.57 [95% CI: 0.49-0.64]). Adding clinical features to radiomics slightly improved performance (C = 0.70 [95% CI: 0.64-0.77]). The combined radiomics and clinical model was validated in the independent testing dataset (C = 0.59 [95% CI: 0.51-0.67], Noether's test P = .02). Conclusions: In this international study, we demonstrate the use of radiomic signatures to create a machine learning model for DIPG prognostication. Standardized, quantitative approaches that objectively measure DIPG changes, including computational MRI evaluation, could offer new approaches to assessing tumor phenotype and serve a future role for optimizing clinical trial eligibility and tumor surveillance.