Classifying intracranial stenosis disease severity from functional MRI data using machine learning.
Translation of many non-invasive hemodynamic MRI methods to cerebrovascular disease patients has been hampered by well-known artifacts associated with delayed blood arrival times and reduced microvascular compliance. Using machine learning and support vector machine (SVM) algorithms, we investigated whether arrival time-related artifacts in these methods could be exploited as novel contrast sources to discriminate angiographically confirmed stenotic flow territories. Intracranial steno-occlusive moyamoya patients (n = 53; age = 45 ± 14.2 years; sex = 43 F) underwent (i) catheter angiography, (ii) anatomical MRI, (iii) cerebral blood flow (CBF)-weighted arterial spin labeling, and (iv) cerebrovascular reactivity (CVR)-weighted hypercapnic blood-oxygenation-level-dependent MRI. Mean, standard deviation (std), and 99th percentile of CBF, CVR, CVRDelay, and CVRMax were calculated in major anterior and posterior flow territories perfused by vessels with vs. without stenosis (≥70%) confirmed by catheter angiography. These and demographic variables were input into SVMs to evaluate discriminatory capacity for stenotic flow territories using k-fold cross-validation and receiver-operating-characteristic-area-under-the-curve to quantify variable combination relevance. Anterior circulation CBF-std, attributable to heterogeneous endovascular signal and prolonged arterial transit times, was the best performing single variable and CVRDelay-mean and CBF-std, both reflective of delayed vascular compliance, were a high-performing two-variable combination (specificity = 0.67; sensitivity = 0.75). Findings highlight the relevance of hemodynamic imaging and machine learning for identifying cerebrovascular impairment.
['Waddle|Spencer L|SL|', 'Juttukonda|Meher R|MR|', 'Lants|Sarah K|SK|', 'Davis|Larry T|LT|', 'Chitale|Rohan|R|', 'Fusco|Matthew R|MR|', 'Jordan|Lori C|LC|', 'Donahue|Manus J|MJ|']
D001921:Brain D016022:Case-Control Studies D002533:Cerebral Angiography D002560:Cerebrovascular Circulation D005260:Female D006801:Humans D007091:Image Processing, Computer-Assisted D000069550:Machine Learning D018810:Magnetic Resonance Angiography D008875:Middle Aged D009072:Moyamoya Disease D012680:Sensitivity and Specificity D012720:Severity of Illness Index D055815:Young Adult
machine learning cerebrovascular disease moyamoya cerebral blood flow cerebrovascular reactivity Stroke