Background: The ability to accurately detect ischemic stroke and predict its neurological recovery is of great clinical value. This study intended to evaluate the performance of whole-brain dynamic radiomics features (DRF) for ischemic stroke detection, neurological impairment assessment, and outcome prediction. Methods: The supervised feature selection (Lasso) and unsupervised feature-selection methods (five-feature dimension-reduction algorithms) were used to generate four experimental groups with DRF in different combinations. Ten machine learning models were used to evaluate their performance by ten-fold cross-validation. Results: In experimental group_A, the best AUCs (0.873 for stroke detection, 0.795 for NIHSS assessment, and 0.818 for outcome prediction) were obtained by outstanding DRF selected by Lasso, and the performance of significant DRF was better than the five-feature dimension-reduction algorithms. The selected outstanding dimension-reduction DRF in experimental group_C obtained a better AUC than dimension-reduction DRF in experimental group_A but were inferior to the outstanding DRF in experimental group_A. When combining the outstanding DRF with each dimension-reduction DRF (experimental group_B), the performance can be improved in ischemic stroke detection (best AUC = 0.899) and NIHSS assessment (best AUC = 0.835) but failed in outcome prediction (best AUC = 0.806). The performance can be further improved when combining outstanding DRF with outstanding dimension-reduction DRF (experimental group_D), achieving the highest AUC scores in all three evaluation items (0.925 for stroke detection, 0.853 for NIHSS assessment, and 0.828 for outcome prediction). By the method in this study, comparing the best AUC of F_t-test in experimental group_A and the best_AUC in experimental group_D, the AUC in stroke detection increased by 19.4% (from 0.731 to 0.925), the AUC in NIHSS assessment increased by 20.1% (from 0.652 to 0.853), and the AUC in prognosis prediction increased by 14.9% (from 0.679 to 0.828). This study provided a potential clinical tool for detailed clinical diagnosis and outcome prediction before treatment.

Accurate and reliable outcome predictions can help evaluate the functional recovery of ischemic stroke patients and assist in making treatment plans. Given that recovery factors may be hidden in the whole-brain features, this study aims to validate the role of dynamic radiomics features (DRFs) in the whole brain, DRFs in local ischemic lesions, and their combination in predicting functional outcomes of ischemic stroke patients. First, the DRFs in the whole brain and the DRFs in local lesions of dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI) images are calculated. Second, the least absolute shrinkage and selection operator (Lasso) is used to generate four groups of DRFs, including the outstanding DRFs in the whole brain (Lasso (WB)), the outstanding DRFs in local lesions (Lasso (LL)), the combination of them (combined DRFs), and the outstanding DRFs in the combined DRFs (Lasso (combined)). Then, the performance of the four groups of DRFs is evaluated to predict the functional recovery in three months. As a result, Lasso (combined) in the four groups achieves the best AUC score of 0.971, which improves the score by 8.9% compared with Lasso (WB), and by 3.5% compared with Lasso (WB) and combined DRFs. In conclusion, the outstanding combined DRFs generated from the outstanding DRFs in the whole brain and local lesions can predict functional outcomes in ischemic stroke patients better than the single DRFs in the whole brain or local lesions.

Cerebrovascular and airway structures are tubular structures used for transporting blood and gases, respectively, providing essential support for the normal activities of the human body. Accurately segmenting these tubular structures is the basis of morphology research and pathological detection. Nevertheless, accurately segmenting these structures from images presents great challenges due to their complex morphological and topological characteristics. To address this challenge, this paper proposes a framework UARAI based on the U-Net multi-scale reverse attention network and sparse convolution network. The framework utilizes a multi-scale structure to effectively extract the global and deep detail features of vessels and airways. Further, it enhances the extraction ability of fine-edged features by a joint reverse attention module. In addition, the sparse convolution structure is introduced to improve the features’ expression ability without increasing the model’s complexity. Finally, the proposed training sample cropping strategy reduces the influence of block boundaries on the accuracy of tubular structure segmentation. The experimental findings demonstrate that the UARAI-based metrics, namely Dice and IoU, achieve impressive scores of 90.31% and 82.33% for cerebrovascular segmentation and 93.34% and 87.51% for airway segmentation, respectively. Compared to commonly employed segmentation techniques, the proposed method exhibits remarkable accuracy and robustness in delineating tubular structures such as cerebrovascular and airway structures. These results hold significant promise in facilitating medical image analysis and clinical diagnosis, offering invaluable support to healthcare professionals.

Cerebrovascular and airway structures are tubular structures used for transporting blood and gases, respectively, providing essential support for the normal activities of the human body. Accurately segmenting these tubular structures is the basis of morphology research and patho-logical detection. Nevertheless, accurately segmenting these structures from images presents great challenges due to their complex morphological and topological characteristics. To address this challenge, this paper proposes a framework UARAI based on the U-Net multi-scale reverse at-tention network and sparse convolution network. The framework utilizes a multi-scale structure to effectively extract the global and deep detail features of vessels and airways. Further, it enhances the extraction ability of fine-edge features by a joint reverse attention module. In addition, the sparse convolution structure is introduced to improve the features' expression ability without increasing the model's complexity. Finally, the proposed training sample cropping strategy re-duces the influence of block boundaries on the accuracy of tubular structure segmentation. The experimental findings demonstrate that the UARAI-based metrics, namely Dice and IoU, achieve impressive scores of 90.31% and 82.33% for cerebrovascular segmentation and 93.34% and 87.51% for airway segmentation, respectively. Compared to commonly employed segmentation tech-niques, the proposed method exhibits remarkable accuracy and robustness in delineating tubular structures such as cerebrovascular and airway. These results hold significant promise in facilitating medical image analysis and clinical diagnosis, offering invaluable support to healthcare profes-sionals.