Quantitative CT radiomics-based models for prediction of haematoma expansion and poor functional outcome in primary intracerebral haemorrhage

Pszczolkowski, S; Manzano-Patron, J P; Law, Z K; Krishnan, K; Ali, A; Bath, P M; Sprigg, N; Dineen, R A

doi:10.1007/s00330-021-07826-9

Surgery for Malignant Acute Ischemic Stroke: A Narrative Review of the Knowns and Unknowns (2023)
Journal Article
Krishnan, K., Hollingworth, M., Nguyen, T. N., Kumaria, A., Kirkman, M. A., Basu, S., …Sprigg, N. (2023). Surgery for Malignant Acute Ischemic Stroke: A Narrative Review of the Knowns and Unknowns. Seminars in Neurology, 43(3), 370-387. https://doi.org/10.1055/s-0043-1771208

Malignant acute ischemic stroke (AIS) is characterized by acute neurological deterioration caused by progressive space-occupying brain edema, often occurring in the first hours to days after symptom onset. Without any treatment, the result is often f... Read More about Surgery for Malignant Acute Ischemic Stroke: A Narrative Review of the Knowns and Unknowns.

Prehospital transdermal glyceryl trinitrate for ultra-acute ischaemic stroke: data from the RIGHT-2 randomised sham-controlled ambulance trial (2023)
Journal Article
Appleton, J. P., Woodhouse, L. J., Anderson, C. S., Ankolekar, S., Cala, L., Dixon, M., …Bath, P. M. (2023). Prehospital transdermal glyceryl trinitrate for ultra-acute ischaemic stroke: data from the RIGHT-2 randomised sham-controlled ambulance trial. Stroke and Vascular Neurology, 9(1), https://doi.org/10.1136/svn-2022-001634

Background The effect of transdermal glyceryl trinitrate (GTN, a nitrovasodilator) on clinical outcome when administered before hospital admission in suspected stroke patients is unclear. Here, we assess the safety and efficacy of GTN in the prespeci... Read More about Prehospital transdermal glyceryl trinitrate for ultra-acute ischaemic stroke: data from the RIGHT-2 randomised sham-controlled ambulance trial.

Measures of intracranial compartments in acute intracerebral haemorrhage: data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial (RIGHT-2) (2022)
Journal Article
Krishnan, K., Law, Z. K., Woodhouse, L. J., Dineen, R. A., Sprigg, N., Wardlaw, J. M., & Bath, P. M. (2023). Measures of intracranial compartments in acute intracerebral haemorrhage: data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial (RIGHT-2). Stroke and Vascular Neurology, 8(2), 151-160. https://doi.org/10.1136/svn-2021-001375

Background and purpose: Intracerebral haemorrhage volume (ICHV) is prognostically important but does not account for intracranial volume (ICV) and cerebral parenchymal volume (CPV). We assessed measures of intracranial compartments in acute ICH using... Read More about Measures of intracranial compartments in acute intracerebral haemorrhage: data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial (RIGHT-2).

Semantic Segmentation of Spontaneous Intracerebral Hemorrhage, Intraventricular Hemorrhage, and Associated Edema on CT Images Using Deep Learning (2022)
Journal Article
Kok, Y. E., Pszczolkowski, S., Law, Z. K., Ali, A., Krishnan, K., Bath, P., …French, A. P. (2022). Semantic Segmentation of Spontaneous Intracerebral Hemorrhage, Intraventricular Hemorrhage, and Associated Edema on CT Images Using Deep Learning. Radiology: Artificial Intelligence, 4(6), https://doi.org/10.1148/ryai.220096

This study evaluated deep learning algorithms for semantic segmentation and quantification of intracerebral hemorrhage (ICH), perihematomal edema (PHE), and intraventricular hemorrhage (IVH) on noncontrast CT scans of patients with spontaneous ICH. M... Read More about Semantic Segmentation of Spontaneous Intracerebral Hemorrhage, Intraventricular Hemorrhage, and Associated Edema on CT Images Using Deep Learning.

External validation of e-ASPECTS software for interpreting brain CT in stroke (2022)
Journal Article
Mair, G., White, P., Bath, P. M., Muir, K. W., Salman, R. A., Martin, C., …Wardlaw, J. M. (2022). External validation of e-ASPECTS software for interpreting brain CT in stroke. Annals of Neurology, 92(6), 943-957. https://doi.org/10.1002/ana.26495

Objective To test e-ASPECTS software in patients with stroke. Marketed as a decision-support tool, e-ASPECTS may detect features of ischemia or hemorrhage on computed tomography (CT) imaging and quantify ischemic extent using ASPECTS (Alberta Strok... Read More about External validation of e-ASPECTS software for interpreting brain CT in stroke.

Outgrowth Endothelial Cell Conditioned Medium Negates TNF-α-Evoked Cerebral Barrier Damage: A Reverse Translational Research to Explore Mechanisms (2022)
Journal Article
Kadir, R. R. A., Alwjwaj, M., Rakkar, K., Othman, O. A., Sprigg, N., Bath, P. M., & Bayraktutan, U. (2022). Outgrowth Endothelial Cell Conditioned Medium Negates TNF-α-Evoked Cerebral Barrier Damage: A Reverse Translational Research to Explore Mechanisms. Stem Cell Reviews and Reports, https://doi.org/10.1007/s12015-022-10439-4

Improved understanding of the key mechanisms underlying cerebral ischemic injury is essential for the discovery of efficacious novel therapeutics for stroke. Through detailed analysis of plasma samples obtained from a large number of healthy voluntee... Read More about Outgrowth Endothelial Cell Conditioned Medium Negates TNF-α-Evoked Cerebral Barrier Damage: A Reverse Translational Research to Explore Mechanisms.

Cerebral Amyloid Angiopathy and the Risk of Hematoma Expansion (2022)
Journal Article
Seiffge, D. J., Polymeris, A. A., Law, Z. K., Krishnan, K., Zietz, A., Thilemann, S., …Peters, N. (2022). Cerebral Amyloid Angiopathy and the Risk of Hematoma Expansion. Annals of Neurology, 92(6), 921-930. https://doi.org/10.1002/ana.26481

Objective: We assessed whether hematoma expansion (HE) and favorable outcome differ according to type of intracerebral hemorrhage (ICH). Methods: Among participants with ICH enrolled in the TICH-2 (Tranexamic Acid for Hyperacute Primary Intracerebral... Read More about Cerebral Amyloid Angiopathy and the Risk of Hematoma Expansion.

UK clinical approaches to address post-stroke fatigue: findings from The Nottingham Fatigue after Stroke study (2022)
Journal Article
Ablewhite, J., Condon, L., das Nair, R., Jones, A., Jones, F., Nouri, F., …Drummond, A. (2022). UK clinical approaches to address post-stroke fatigue: findings from The Nottingham Fatigue after Stroke study. International Journal of Therapy and Rehabilitation, 29(5), 1-12. https://doi.org/10.12968/ijtr.2021.0163

Background/aims Although post-stroke is common and debilitating, there is little published research on how it is managed by clinicians. The aim of this study was to document UK management of post-stroke fatigue and ascertain whether there are any dif... Read More about UK clinical approaches to address post-stroke fatigue: findings from The Nottingham Fatigue after Stroke study.

Inhibition of oxidative stress delays senescence and augments functional capacity of endothelial progenitor cells (2022)
Journal Article
Reskiawan A. Kadir, R., Alwjwaj, M., Ahmad Othman, O., Rakkar, K., Sprigg, N., Bath, P. M., & Bayraktutan, U. (2022). Inhibition of oxidative stress delays senescence and augments functional capacity of endothelial progenitor cells. Brain Research, 1787, Article 147925. https://doi.org/10.1016/j.brainres.2022.147925

Ageing is characterised by a progressive loss of vascular endothelial function and integrity. Endothelial progenitor cells (EPCs) play an integral role in endothelial regeneration but are prone to age-dependent changes which may accelerate their sene... Read More about Inhibition of oxidative stress delays senescence and augments functional capacity of endothelial progenitor cells.

Effect of Tranexamic Acid Administration on Remote Cerebral Ischemic Lesions in Acute Spontaneous Intracerebral Hemorrhage: A Substudy of a Randomized Clinical Trial (2022)
Journal Article
Pszczolkowski, S., Sprigg, N., Woodhouse, L. J., Gallagher, R., Swienton, D., Law, Z. K., …Dineen, R. A. (2022). Effect of Tranexamic Acid Administration on Remote Cerebral Ischemic Lesions in Acute Spontaneous Intracerebral Hemorrhage: A Substudy of a Randomized Clinical Trial. JAMA Neurology, 79(5), 468-477. https://doi.org/10.1001/jamaneurol.2022.0217

Importance: Hyperintense foci on diffusion-weighted imaging (DWI) that are spatially remote from the acute hematoma occur in 20% of people with acute spontaneous intracerebral hemorrhage (ICH). Tranexamic acid, a hemostatic agent that is under invest... Read More about Effect of Tranexamic Acid Administration on Remote Cerebral Ischemic Lesions in Acute Spontaneous Intracerebral Hemorrhage: A Substudy of a Randomized Clinical Trial.

Association between time to treatment and clinical outcomes in endovascular thrombectomy beyond 6 hours without advanced imaging selection (2022)
Journal Article
Dhillon, P. S., Butt, W., Podlasek, A., McConachie, N., Lenthall, R., Nair, S., …England, T. J. (2023). Association between time to treatment and clinical outcomes in endovascular thrombectomy beyond 6 hours without advanced imaging selection. Journal of NeuroInterventional Surgery, 15(4), 336-342. https://doi.org/10.1136/neurintsurg-2021-018564

Background: The effectiveness and safety of endovascular thrombectomy (EVT) in the late window (6-24 hours) for acute ischemic stroke (AIS) patients selected without advanced imaging is undetermined. We aimed to assess clinical outcomes and the relat... Read More about Association between time to treatment and clinical outcomes in endovascular thrombectomy beyond 6 hours without advanced imaging selection.

Effect of continuing versus stopping pre-stroke antihypertensive agents within 12h on outcome after stroke: A subgroup analysis of the efficacy of nitric oxide in stroke (ENOS) trial (2022)
Journal Article
Woodhouse, L. J., Appleton, J. P., Scutt, P., Everton, L., Wilkinson, G., Caso, V., …Bath, P. M. (2022). Effect of continuing versus stopping pre-stroke antihypertensive agents within 12h on outcome after stroke: A subgroup analysis of the efficacy of nitric oxide in stroke (ENOS) trial. eClinicalMedicine, 44, Article 101274. https://doi.org/10.1016/j.eclinm.2022.101274

Background: It is not known whether to continue or temporarily stop existing antihypertensive drugs in patients with acute stroke. Methods: We performed a prospective subgroup analysis of patients enrolled into the Efficacy of Nitric Oxide in Stroke... Read More about Effect of continuing versus stopping pre-stroke antihypertensive agents within 12h on outcome after stroke: A subgroup analysis of the efficacy of nitric oxide in stroke (ENOS) trial.

Automated Detection of Candidate Subjects With Cerebral Microbleeds Using Machine Learning (2022)
Journal Article
Sundaresan, V., Arthofer, C., Zamboni, G., Dineen, R. A., Rothwell, P. M., Sotiropoulos, S. N., …Griffanti, L. (2022). Automated Detection of Candidate Subjects With Cerebral Microbleeds Using Machine Learning. Frontiers in Neuroinformatics, 15, Article 777828. https://doi.org/10.3389/fninf.2021.777828

Cerebral microbleeds (CMBs) appear as small, circular, well defined hypointense lesions of a few mm in size on T2*-weighted gradient recalled echo (T2*-GRE) images and appear enhanced on susceptibility weighted images (SWI). Due to their small size,... Read More about Automated Detection of Candidate Subjects With Cerebral Microbleeds Using Machine Learning.

Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial (2022)
Journal Article
Tunnage, B., Woodhouse, L. J., Dixon, M., Anderson, C. S., Ankolekar, S., Appleton, J. P., …Bath, P. M. (2022). Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial. BMC Emergency Medicine, 22(1), Article 2. https://doi.org/10.1186/s12873-021-00560-x

Background: Prehospital stroke trials will inevitably recruit patients with non-stroke conditions, so called stroke mimics. We undertook a pre-specified analysis to determine outcomes in patients with mimics in the second Rapid Intervention with Glyc... Read More about Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial.

Brief Consent Methods Enable Rapid Enrollment in Acute Stroke Trial: Results From the TICH-2 Randomized Controlled Trial (2021)
Journal Article
the TICH-2 Investigators, Law, Z. K., Appleton, J. P., Scutt, P., Roberts, I., Al-Shahi Salman, R., …Sprigg, N. (2021). Brief Consent Methods Enable Rapid Enrollment in Acute Stroke Trial: Results From the TICH-2 Randomized Controlled Trial. Stroke, 53(4), 1141-1148. https://doi.org/10.1161/STROKEAHA.121.035191

Background: Seeking consent rapidly in acute stroke trials is crucial as interventions are time sensitive. We explored the association between consent pathways and time to enrollment in the TICH-2 (Tranexamic Acid in Intracerebral Haemorrhage-2) rand... Read More about Brief Consent Methods Enable Rapid Enrollment in Acute Stroke Trial: Results From the TICH-2 Randomized Controlled Trial.

Statistical reanalysis of vascular event outcomes in primary and secondary vascular prevention trials (2021)
Journal Article
Woodhouse, L. J., Montgomery, A. A., Mant, J., Davis, B. R., Algra, A., Mas, J., …Bath, P. M. (2021). Statistical reanalysis of vascular event outcomes in primary and secondary vascular prevention trials. BMC Medical Research Methodology, 21, Article 218. https://doi.org/10.1186/s12874-021-01388-6

Background: Vascular prevention trials typically use dichotomous event outcomes although this may be inefficient statistically and gives no indication of event severity. We assessed whether ordinal outcomes would be more efficient and how to best ana... Read More about Statistical reanalysis of vascular event outcomes in primary and secondary vascular prevention trials.

Managing post-stroke fatigue: A qualitative study to explore multifaceted clinical perspectives (2021)
Journal Article
Drummond, A., Nouri, F., Ablewhite, J., Condon, L., Das Nair, R., Jones, A., …Thomas, S. (2022). Managing post-stroke fatigue: A qualitative study to explore multifaceted clinical perspectives. British Journal of Occupational Therapy, 85(7), 505-512. https://doi.org/10.1177/03080226211042269

Introduction: Post-stroke fatigue (PSF) is common and debilitating. However, while its effective management is a priority for clinicians and stroke survivors, there remains little evidence to provide guidance or underpin practice. Our aim, therefore,... Read More about Managing post-stroke fatigue: A qualitative study to explore multifaceted clinical perspectives.

Tranexamic Acid for Prevention of Hematoma Expansion in Intracerebral Hemorrhage Patients With or Without Spot Sign (2021)
Journal Article
Ovesen, C., Jakobsen, J. C., Gluud, C., Steiner, T., Law, Z., Flaherty, K., …Christensen, H. (2021). Tranexamic Acid for Prevention of Hematoma Expansion in Intracerebral Hemorrhage Patients With or Without Spot Sign. Stroke, 52(8), 2629-2636. https://doi.org/10.1161/strokeaha.120.032426

Background and Purpose: The computed tomography angiography or contrast-enhanced computed tomography based spot sign has been proposed as a biomarker for identifying on-going hematoma expansion in patients with acute intracerebral hemorrhage. We inv... Read More about Tranexamic Acid for Prevention of Hematoma Expansion in Intracerebral Hemorrhage Patients With or Without Spot Sign.

Quantitative CT radiomics-based models for prediction of haematoma expansion and poor functional outcome in primary intracerebral haemorrhage (2021)
Journal Article
Pszczolkowski, S., Manzano-Patrón, J. P., Law, Z. K., Krishnan, K., Ali, A., Bath, P. M., …Dineen, R. A. (2021). Quantitative CT radiomics-based models for prediction of haematoma expansion and poor functional outcome in primary intracerebral haemorrhage. European Radiology, 31, 7945-7959. https://doi.org/10.1007/s00330-021-07826-9

Objectives: To test radiomics-based features extracted from noncontrast CT of patients with spontaneous intracerebral haemorrhage for prediction of haematoma expansion and poor functional outcome and compare them with radiological signs and clinical... Read More about Quantitative CT radiomics-based models for prediction of haematoma expansion and poor functional outcome in primary intracerebral haemorrhage.

Quantitative CT radiomics-based models for prediction of haematoma expansion and poor functional outcome in primary intracerebral haemorrhage (2021)
Journal Article
Pszczolkowski, S., Manzano-Patron, J. P., Law, Z. K., Krishnan, K., Ali, A., Bath, P. M., …Dineen, R. A. (2021). Quantitative CT radiomics-based models for prediction of haematoma expansion and poor functional outcome in primary intracerebral haemorrhage. European Radiology, 31, 7945-7959. https://doi.org/10.1007/s00330-021-07826-9

Objectives To test radiomics-based features extracted from noncontrast CT of patients with spontaneous intracerebral haemorrhage for prediction of haematoma expansion and poor functional outcome and compare them with radiological signs and clinica... Read More about Quantitative CT radiomics-based models for prediction of haematoma expansion and poor functional outcome in primary intracerebral haemorrhage.

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