TY  - JOUR
A1  - Fabritius, Matthias Philipp
A1  - Wölfer, Teresa A.
A1  - Herzberg, Moriz
A1  - Tiedt, Steffen
A1  - Puhr-Westerheide, Daniel
A1  - Grosu, Sergio
A1  - Maurus, Stefan
A1  - Geyer, Thomas
A1  - Curta, Adrian
A1  - Kellert, Lars
A1  - Küpper, Clemens
A1  - Liebig, Thomas
A1  - Ricke, Jens
A1  - Dimitriadis, Konstantinos
A1  - Kunz, Wolfgang G.
A1  - Zimmermann, Hanna
A1  - Reidler, Paul
T1  - Course of early neurologic symptom severity after endovascular treatment of anterior circulation large vessel occlusion stroke: association with baseline multiparametric CT imaging and clinical parameters
JF  - Diagnostics
N2  - Background: Neurologic symptom severity and deterioration at 24 hours (h) predict long-term outcomes in patients with acute large vessel occlusion (LVO) stroke of the anterior circulation. We aimed to examine the association of baseline multiparametric CT imaging and clinical factors with the course of neurologic symptom severity in the first 24 h after endovascular treatment (EVT). Methods: Patients with LVO stroke of the anterior circulation were selected from a prospectively acquired consecutive cohort of patients who underwent multiparametric CT, including non-contrast CT, CT angiography and CT perfusion before EVT. The symptom severity was assessed on admission and after 24 h using the 42-point National Institutes of Health Stroke Scale (NIHSS). Clinical and imaging data were compared between patients with and without early neurological deterioration (END). END was defined as an increase in ≥4 points, and a significant clinical improvement as a decrease in ≥4 points, compared to NIHSS on admission. Multivariate regression analyses were used to determine independent associations of imaging and clinical parameters with NIHSS score increase or decrease in the first 24 h. Results: A total of 211 patients were included, of whom 38 (18.0%) had an END. END was significantly associated with occlusion of the internal carotid artery (odds ratio (OR), 4.25; 95% CI, 1.90–9.47) and the carotid T (OR, 6.34; 95% CI, 2.56–15.71), clot burden score (OR, 0.79; 95% CI, 0.68–0.92) and total ischemic volume (OR, 1.01; 95% CI, 1.00–1.01). In a comprehensive multivariate analysis model including periprocedural parameters and complications after EVT, carotid T occlusion remained independently associated with END, next to reperfusion status and intracranial hemorrhage. Favorable reperfusion status and small ischemic core volume were associated with clinical improvement after 24 h. Conclusions: The use of imaging parameters as a surrogate for early NIHSS progression in an acute LVO stroke after EVT reached limited performance with only carotid T occlusion as an independent predictor of END. Reperfusion status and early complications in terms of intracranial hemorrhage are critical factors that influence patient outcome in the acute stroke phase after EVT.
KW  - stroke
KW  - large vessel occlusion
KW  - multiparametric CT
KW  - CT perfusion
KW  - CT angiography
KW  - NIHSS
KW  - EVT
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-242681
SN  - 2075-4418
VL  - 11
IS  - 7
ER  - 
TY  - JOUR
A1  - Woźnicki, Piotr
A1  - Laqua, Fabian Christopher
A1  - Messmer, Katharina
A1  - Kunz, Wolfgang Gerhard
A1  - Stief, Christian
A1  - Nörenberg, Dominik
A1  - Schreier, Andrea
A1  - Wójcik, Jan
A1  - Ruebenthaler, Johannes
A1  - Ingrisch, Michael
A1  - Ricke, Jens
A1  - Buchner, Alexander
A1  - Schulz, Gerald Bastian
A1  - Gresser, Eva
T1  - Radiomics for the prediction of overall survival in patients with bladder cancer prior to radical cystectomy
JF  - Cancers
N2  - (1) Background: To evaluate radiomics features as well as a combined model with clinical parameters for predicting overall survival in patients with bladder cancer (BCa). (2) Methods: This retrospective study included 301 BCa patients who received radical cystectomy (RC) and pelvic lymphadenectomy. Radiomics features were extracted from the regions of the primary tumor and pelvic lymph nodes as well as the peritumoral regions in preoperative CT scans. Cross-validation was performed in the training cohort, and a Cox regression model with an elastic net penalty was trained using radiomics features and clinical parameters. The models were evaluated with the time-dependent area under the ROC curve (AUC), Brier score and calibration curves. (3) Results: The median follow-up time was 56 months (95% CI: 48–74 months). In the follow-up period from 1 to 7 years after RC, radiomics models achieved comparable predictive performance to validated clinical parameters with an integrated AUC of 0.771 (95% CI: 0.657–0.869) compared to an integrated AUC of 0.761 (95% CI: 0.617–0.874) for the prediction of overall survival (p = 0.98). A combined clinical and radiomics model stratified patients into high-risk and low-risk groups with significantly different overall survival (p < 0.001). (4) Conclusions: Radiomics features based on preoperative CT scans have prognostic value in predicting overall survival before RC. Therefore, radiomics may guide early clinical decision-making.
KW  - bladder cancer
KW  - radical cystectomy
KW  - radiomics
KW  - outcome prediction
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-288098
SN  - 2072-6694
VL  - 14
IS  - 18
ER  -