title: Feasibility and Diagnostic Accuracy of Ischemic Stroke Territory Recognition Based on Two-Dimensional Projections of Three-Dimensional Diffusion MRI Data.
abstract: This study was conducted to assess the feasibility and diagnostic accuracy of brain artery territory recognition based on geoprojected two-dimensional maps of diffusion MRI data in stroke patients. In this retrospective study, multiplanar diffusion MRI data of ischemic stroke patients was used to create a two-dimensional map of the entire brain. To guarantee correct representation of the stroke, a computer-aided brain artery territory diagnosis was developed and tested for its diagnostic accuracy. The test recognized the stroke-affected brain artery territory based on the position of the stroke in the map. The performance of the test was evaluated by comparing it to the reference standard of each patient's diagnosed stroke territory on record. This study was designed and conducted according to Standards for Reporting of Diagnostic Accuracy (STARD). The statistical analysis included diagnostic accuracy parameters, cross-validation, and Youden Index optimization. After cross-validation on a cohort of 91 patients, the sensitivity of this territory diagnosis was 81% with a specificity of 87%. With this, the projection of strokes onto a two-dimensional map is accurate for representing the affected stroke territory and can be used to provide a static and printable overview of the diffusion MRI data. The projected map is compatible with other two-dimensional data such as EEG and will serve as a useful visualization tool.
authors.affiliation: Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg , Erlangen , Germany.
authors.forename: Jana Katharina
authors.initials: JK
authors.lastname: Wrosch
authors.affiliation: Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg , Erlangen , Germany ; Department of Neurology, Friedrich-Alexander University of Erlangen-Nuremberg , Erlangen , Germany.
authors.forename: Bastian
authors.initials: B
authors.lastname: Volbers
authors.affiliation: Department of Neuroradiology, Friedrich-Alexander University of Erlangen-Nuremberg , Erlangen , Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Gölitz
authors.affiliation: Institute of Medical Biotechnology, Friedrich-Alexander University of Erlangen-Nuremberg , Erlangen , Germany.
authors.forename: Daniel Frederic
authors.initials: DF
authors.lastname: Gilbert
authors.affiliation: Department of Neurology, Friedrich-Alexander University of Erlangen-Nuremberg , Erlangen , Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schwab
authors.affiliation: Department of Neuroradiology, Friedrich-Alexander University of Erlangen-Nuremberg , Erlangen , Germany.
authors.forename: Arnd
authors.initials: A
authors.lastname: Dörfler
authors.affiliation: Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg , Erlangen , Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Kornhuber
authors.affiliation: Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg , Erlangen , Germany ; Psychiatric and Neurological Ambulatory Care Office , Bamberg , Germany.
authors.forename: Teja Wolfgang
authors.initials: TW
authors.lastname: Groemer
keywords: computer-aided detection and diagnosis; diffusion-weighted imaging; dimensionality reduction; magnetic resonance imaging; stroke territories; validation; visualization