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Diagnosis of Pulmonary Hypertension from Magnetic Resonance Imaging–Based Computational Models and Decision Tree Analysis

Title: Diagnosis of Pulmonary Hypertension from Magnetic Resonance Imaging–Based Computational Models and Decision Tree Analysis
Authors: Lungu, Angela; Swift, Andrew J.; Capener, David; Kiely, David; Hose, Rod; Wild, Jim M.
Contributors: Engineering and Physical Sciences Research Council; National Institute on Handicapped Research; University of Sheffield
Source: Pulmonary Circulation ; volume 6, issue 2, page 181-190 ; ISSN 2045-8940 2045-8940
Publisher Information: Wiley
Publication Year: 2016
Collection: Wiley Online Library (Open Access Articles via Crossref)
Description: Accurately identifying patients with pulmonary hypertension (PH) using noninvasive methods is challenging, and right heart catheterization (RHC) is the gold standard. Magnetic resonance imaging (MRI) has been proposed as an alternative to echocardiography and RHC in the assessment of cardiac function and pulmonary hemodynamics in patients with suspected PH. The aim of this study was to assess whether machine learning using computational modeling techniques and image‐based metrics of PH can improve the diagnostic accuracy of MRI in PH. Seventy‐two patients with suspected PH attending a referral center underwent RHC and MRI within 48 hours. Fifty‐seven patients were diagnosed with PH, and 15 had no PH. A number of functional and structural cardiac and cardiovascular markers derived from 2 mathematical models and also solely from MRI of the main pulmonary artery and heart were integrated into a classification algorithm to investigate the diagnostic utility of the combination of the individual markers. A physiological marker based on the quantification of wave reflection in the pulmonary artery was shown to perform best individually, but optimal diagnostic performance was found by the combination of several image‐based markers. Classifier results, validated using leave‐one‐out cross validation, demonstrated that combining computation‐derived metrics reflecting hemodynamic changes in the pulmonary vasculature with measurement of right ventricular morphology and function, in a decision support algorithm, provides a method to noninvasively diagnose PH with high accuracy (92%). The high diagnostic accuracy of these MRI‐based model parameters may reduce the need for RHC in patients with suspected PH.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1086/686020
Availability: https://doi.org/10.1086/686020; https://onlinelibrary.wiley.com/doi/pdf/10.1086/686020; https://onlinelibrary.wiley.com/doi/full-xml/10.1086/686020
Rights: http://onlinelibrary.wiley.com/termsAndConditions#vor ; http://journals.sagepub.com/page/policies/text-and-data-mining-license
Accession Number: edsbas.86F551E3
Database: BASE