A Hybrid Transformer-Convolutional Neural Network for Segmentation of Intracerebral Hemorrhage and Perihematomal Edema on Non-Contrast Head Computed Tomography (CT) with Uncertainty Quantification to Improve Confidence.

Intracerebral hemorrhage (ICH) and perihematomal edema (PHE) are key imaging markers of primary and secondary brain injury in hemorrhagic stroke. Accurate segmentation and quantification of ICH and PHE can help with prognostication and guide treatment planning. In this study, we combined Swin-Unet Transformers with nnU-NETv2 convolutional network for segmentation of ICH and PHE on non-contrast head CTs.

Machine Learning Models for 3-Month Outcome Prediction Using Radiomics of Intracerebral Hemorrhage and Perihematomal Edema from Admission Head Computed Tomography (CT).

: Intracerebral hemorrhages (ICH) and perihematomal edema (PHE) are respective imaging markers of primary and secondary brain injury in hemorrhagic stroke. In this study, we explored the potential added value of PHE radiomic features for prognostication in ICH patients. : Using a multicentric trial cohort of acute supratentorial ICH ( = 852) patients, we extracted radiomic features from ICH and PHE lesions on admission non-contrast head CTs.

Association between Heat Vulnerability Index and Stroke Severity.

Background: Socioeconomically disadvantaged neighborhoods are particularly vulnerable to heat-related illnesses. We aim to investigate the association between the heat vulnerability index (HVI), an established neighborhood-level metric of heat-related mortality risk, and acute ischemic stroke (AIS) severity.

Methods: We conducted a retrospective analysis of consecutive AIS admissions to a comprehensive stroke center between 2012 and 2021.

Ten-year trends, disparities, and clinical impact of stroke thrombectomy and thrombolysis: A single center experience 2012-2021.

Objectives: As indications for acute ischemic stroke treatment expand, it is unclear whether disparities in treatment utilization and outcome still exist. The main objective of this study was to investigate disparities in acute ischemic stroke treatment and determine impact on outcome.

Materials And Methods: Retrospective observational cohort study of consecutive ischemic stroke admissions to a comprehensive stroke center from 2012-2021 was performed.

Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion.

Purpose: To create and validate an automated pipeline for detection of early signs of irreversible ischemic change from admission CTA in patients with large vessel occlusion (LVO) stroke.

Methods: We retrospectively included 368 patients for training and 143 for external validation. All patients had anterior circulation LVO stroke, endovascular therapy with successful reperfusion, and follow-up diffusion-weighted imaging (DWI).

Radiomics-Based Prediction of Collateral Status from CT Angiography of Patients Following a Large Vessel Occlusion Stroke.

Background: A major driver of individual variation in long-term outcomes following a large vessel occlusion (LVO) stroke is the degree of collateral arterial circulation. We aimed to develop and evaluate machine-learning models that quantify LVO collateral status using admission computed tomography angiography (CTA) radiomics.

Methods: We extracted 1116 radiomic features from the anterior circulation territories from admission CTAs of 600 patients experiencing an acute LVO stroke.

Uncertainty-aware deep-learning model for prediction of supratentorial hematoma expansion from admission non-contrast head computed tomography scan.

Hematoma expansion (HE) is a modifiable risk factor and a potential treatment target in patients with intracerebral hemorrhage (ICH). We aimed to train and validate deep-learning models for high-confidence prediction of supratentorial ICH expansion, based on admission non-contrast head Computed Tomography (CT). Applying Monte Carlo dropout and entropy of deep-learning model predictions, we estimated the model uncertainty and identified patients at high risk of HE with high confidence.

Maternal and Fetal Radiation-Induced Cancer Risk From Computed Tomography Pulmonary Angiography During Pregnancy: A Retrospective Cohort Study Across a Multihospital Integrated Health Care Network.

Objective: Computed tomography pulmonary angiogram (CTPA) is important to evaluate suspected pulmonary embolism in pregnancy but has maternal/fetal radiation risks. The objective of this study was to estimate maternal and fetal radiation-induced cancer risk from CTPA during pregnancy.

Methods: Simulation modeling via the National Cancer Institute's Radiation Risk Assessment Tool was used to estimate excess cancer risks from 17 organ doses from CTPA during pregnancy, with doses determined by a radiation dose indexing monitoring system.

Time-driven activity-based costing (TDABC) of direct-to-angiography pathway for acute ischemic stroke patients with suspected large vessel occlusion.

Introduction: Direct-to-angiography (DTA) is a novel care pathway for endovascular treatment (EVT) of acute ischemic stroke (AIS) that has been shown to reduce time-to-treatment and improve clinical outcomes for EVT-eligible patients. The institutional costs of adopting the DTA pathway and the many factors affecting costs have not been studied. In this study, we assess the costs and main cost drivers associated with the DTA pathway compared to the conventional CT pathway for patients presenting with AIS and suspected LVO in the anterior circulation.

Peri-hematomal edema shape features related to 3-month outcome in acute supratentorial intracerebral hemorrhage.

Introduction: Perihematomal edema (PHE) represents secondary brain injury and a potential treatment target in intracerebral hemorrhage (ICH). However, studies differ on optimal PHE volume metrics as prognostic factor(s) after spontaneous, non-traumatic ICH. This study examines associations of baseline and 24-h PHE shape features with 3-month outcomes.

Ten-Year Trend in Advanced Imaging Utilization for Suspected Pulmonary Embolism in Pregnancy.

Purpose: Advanced imaging is essential to diagnose pulmonary embolism (PE) in pregnancy, but there are associated maternal and fetal radiation risks. The purpose of this study was to evaluate the 10-year trend in advanced imaging utilization for the evaluation of suspected PE in pregnancy.

Methods: The authors evaluated pregnant women with advanced imaging using CT pulmonary angiography (CTPA) or lung scintigraphy (LS) for evaluation of suspected PE presenting to two tertiary hospitals from 2007 to 2016.

Sociodemographic Factors and Screening CT Colonography Use Among Medicare Beneficiaries.

Approximately one-third of the eligible U.S. population have not undergone guideline-compliant colorectal cancer (CRC) screening.

Acute ischemic stroke outcomes in patients with COVID-19: a systematic review and meta-analysis.

Background: Although patients with COVID-19 have a higher risk of acute ischemic stroke (AIS), the impact on stroke outcomes remains uncertain.

Aims: To determine the clinical outcomes of patients with AIS and COVID-19 (AIS-COVID+).

Methods: We performed a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines.

Cost-Effectiveness Analysis of Ga-DOTATATE PET/MRI in Radiotherapy Planning in Patients with Intermediate-Risk Meningioma.

Background And Purpose: While contrast-enhanced MR imaging is the criterion standard in meningioma diagnosis and treatment response assessment, gallium Ga-DOTATATE PET/MR imaging has increasingly demonstrated utility in meningioma diagnosis and management. Integrating Ga-DOTATATE PET/MR imaging in postsurgical radiation planning reduces the planning target volume and organ-at-risk dose. However, Ga-DOTATATE PET/MR imaging is not widely implemented in clinical practice due to higher perceived costs.

Industry Payments to Radiologists During the Last 5 Years and Impact of COVID-19 Pandemic.

Objective: The aim of this study is to assess the trends in industry payments to radiologists and the impact of the COVID-19 pandemic, including trends in different categories of payments.

Methods: The Open Payments Database from CMS was accessed and analyzed for the period from January 1, 2016, to December 31, 2021. Payments were grouped into six categories: consulting fees, education, gifts, research, speaker fees, and royalties or ownership.

Patient and Fetal Radiation-Induced Malignancy Risk From Imaging For Evaluation of Pulmonary Embolism in Pregnancy.

Background: Imaging for diagnosis of suspected pulmonary embolism in pregnancy presents radiation concerns for patient and fetus.

Objectives: Estimate the risks of radiation-induced breast cancer and childhood leukemia from common imaging techniques for the evaluation of suspected pulmonary embolism in pregnancy.

Methods: Breast and uterine absorbed doses for various imaging techniques were input into the National Cancer Institute Radiation Risk Assessment Tool to calculate risk of breast cancer for the patient and childhood leukemia for the fetus.

Cost-effectiveness of remote robotic mechanical thrombectomy in acute ischemic stroke.

Objective: Clinical outcomes following endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) treatment are highly time sensitive. Remote robotic (RR)-EVT systems may be capable of mitigating time delays in patient transfer from a primary stroke center (PSC) to a comprehensive/thrombectomy-capable stroke center. However, health economic evidence is needed to assess the costs and benefits of an RR-EVT system.

Drivers of Ischemic Stroke Hospital Cost Trends Among Older Adults in the United States.

Purpose: The increased use of neuroimaging and innovations in ischemic stroke (IS) treatment have improved outcomes, but the impact on median hospital costs is not well understood.

Methods: A retrospective study was conducted using Medicare 5% claims data for 75,525 consecutive index IS hospitalizations for patients aged ≥65 years from 2012 to 2019 (values in 2019 dollars). IS episode cost was calculated in each year for trend analysis and stratified by cost components, including neuroimaging (CT angiography [CTA], CT perfusion [CTP], MRI, and MR angiography [MRA]), treatment (endovascular thrombectomy [EVT] and/or intravenous thrombolysis), and patient sociodemographic factors.

Cost-effectiveness of endovascular thrombectomy in acute stroke patients with large ischemic core.

Background: Evidence has shown that endovascular thrombectomy (EVT) treatment improves clinical outcomes. Yet, its benefit remains uncertain in patients with large established infarcts as defined by ASPECTS (Alberta Stroke Program Early CT Score) <6. This study evaluates the cost-effectiveness of EVT, compared with standard care (SC), in acute ischemic stroke (AIS) patients with ASPECTS 3-5.

Utilization of a Guideline-recommended Imaging Paradigm for Pregnant Patients With Suspicion of Pulmonary Embolism.

Purpose: A dose reduction imaging paradigm utilizing chest x-ray (CXR) to triage between computed tomography pulmonary angiography (CTPA) and lung scintigraphy (LS) was introduced in 2001 and adopted in 2012 by the American Thoracic Society/Society of Thoracic Radiology (ATS) guideline for the evaluation of pulmonary embolism in pregnancy. We aimed to assess the utilization of this imaging paradigm preadoption and postadoption by the ATS guideline, and identify factors associated with its utilization.

Materials And Methods: This retrospective cohort study evaluated consecutive pregnant patients who received CTPA or LS for the evaluation of pulmonary embolism in pregnancy at 2 tertiary hospitals between September 2008 and March 2017, excluding 2012 for guideline release washout.

Dataset on acute stroke risk stratification from CT angiographic radiomics.

With advances in high-throughput image processing technologies and increasing availability of medical mega-data, the growing field of radiomics opened the door for quantitative analysis of medical images for prediction of clinically relevant information. One clinical area in which radiomics have proven useful is stroke neuroimaging, where rapid treatment triage is vital for patient outcomes and automated decision assistance tools have potential for significant clinical impact. Recent research, for example, has applied radiomics features extracted from CT angiography (CTA) images and a machine learning framework to facilitate risk-stratification in acute stroke.