| Title: |
Multicenter Validation of Synthetic FLAIR as a substitute for FLAIR Sequence in Acute Ischemic Stroke |
| Authors: |
Hamon, Guillaume; Legrand, Laurence; Hmeydia, Ghazi; Turc, Guillaume; Hassen, Wagih Ben; Charron, Sylvain; Debacker, Clement; Naggara, Olivier; Thirion, Bertrand; Chen, Bailiang; Lapergue, Bertrand; Oppenheim, Catherine; Benzakoun, Joseph |
| Contributors: |
Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité); Groupe hospitalier universitaire Paris psychiatrie & neurosciences Paris (GHU Paris Psychiatrie et Neurosciences); FHU NeuroVasc Site Sainte-Anne, Paris (GHU-PPN); Centre Hospitalier Sainte Anne Paris; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité); Modèles et inférence pour les données de Neuroimagerie (MIND); IFR49 - Neurospin - CEA; Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre Inria de l'Université Paris-Saclay; Centre Inria de Saclay; Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre Inria de Saclay; Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria); Centre d'investigation clinique Nancy (CIC); Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL); Foch Hospital; Université de Versailles Saint-Quentin-en-Yvelines (UVSQ); ANR-18-RHUS-0001,BOOSTER,Brain clOt persOnalized therapeutic Strategies for sTroke Emergent Reperfusion(2018) |
| Source: |
ISSN: 2396-9873. |
| Publisher Information: |
CCSD; Sage Publications |
| Publication Year: |
2024 |
| Subject Terms: |
Acute stroke; DWI-FLAIR mismatch; ischemic stroke; synthetic FLAIR; [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| Description: |
International audience ; Purpose: To evaluate performance of synthetic and real FLAIR for identifying early stroke in a multicenter cohort. Methods: This retrospective study was conducted using DWI and FLAIR extracted from the Endovascular Treatment in Ischemic Stroke image registry (2017–2021). The database was partitioned into subsets according to MRI field strength and manufacturer, and randomly divided into training set (70%) used for model fine-tuning, validation set (15%), and test set (15%). In test set, five readers, blinded to FLAIR sequence type, assessed DWI-FLAIR mismatch using real and synthetic FLAIR. Interobserver agreement for DWI-FLAIR rating and concordance between synthetic and real FLAIR were evaluated with kappa statistics. Sensitivity and specificity for identification of ⩽4.5 h AIS were compared in patients with known onset-to-MRI delay using McNemar’s test. Results: 1454 complete MRI sets (1172 patients, median (IQR) age: 73 years (62–82); 762 women) acquired on 125 MRI units were analyzed. In test set (207 MRI), interobserver reproducibility for DWI-FLAIR mismatch labeling was substantial for real and synthetic FLAIR (Fleiss κ = 0.79 (95%CI: 0.73–0.84) and 0.77 (95%CI: 0.71–0.82), respectively). After consensus, concordance between real and synthetic FLAIR was excellent (κ = 0.85 (95%CI: 0.78–0.92)). In 141 MRI sets with known onset-to-MRI delay, diagnostic performances for ⩽4.5 h AIS identification did not differ between real and synthetic FLAIR (sensitivity: 60/71 (85%) vs 59/71 (83%), p = .56; specificity: 65/70 (93%) vs 65/70 (93%), p > 0.99). Conclusion: A deep-learning-based FLAIR fine-tuned on multicenter data can provide comparable performances to real FLAIR for early AIS identification. This approach may help reducing MR protocol duration and motion artifacts. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/39096195; PUBMED: 39096195 |
| DOI: |
10.1177/23969873241263418 |
| Availability: |
https://inserm.hal.science/inserm-04667549; https://inserm.hal.science/inserm-04667549v1/document; https://inserm.hal.science/inserm-04667549v1/file/Hamon%20et%20al%202024%20%28Oppenheim%20%26%20Turc%29%20ESO-24-0232.R1.pdf; https://doi.org/10.1177/23969873241263418 |
| Rights: |
http://creativecommons.org/licenses/by/ ; info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.46868F77 |
| Database: |
BASE |