Data_Sheet_1_Antiplatelet therapy adjustment improved the radiomic characteristics of acute silent cerebral infarction after stent-assisted coiling in patients with high on-treatment platelet reactivity: A prospective study.pdf

BackgroundWe aimed to investigate the effects of high on-treatment platelet reactivity (HPR) and antiplatelet therapy adjustment on high-risk radiomic features in patients with antiplatelet therapy adjustment on acute silent cerebral infarction (ASCI) who had unruptured intracranial aneurysms (UIA) after stent placement.
MethodsThis single-institution study prospectively included 230 UIA patients who had ACSI after stent placement in our hospital between January 2015 and July 2020. All patients underwent magnetic resonance imaging with diffusion-weighted imaging (MRI-DWI) after stent placement and 1,485 radiomic features were extracted from each patient. The least absolute shrinkage and selection operator regression methods were used for selection of high-risk radiomic features associated with clinical symptoms. In addition, 199 patients with ASCI were classified into three groups: controls without HPR (n = 113), HPR patients with standard antiplatelet therapy (n = 63) and HPR patients with antiplatelet therapy adjustment (n = 23). We compared high-risk radiomic features between three groups.
ResultsOf the patients who had acute infarction after MRI-DWI, 31 (13.5%) exhibited clinical symptoms. Eight risk radiomic features associated with clinical symptoms were selected, and the radiomics signature exhibited good performance. In ASCI patients, compared with controls, the radiomic characteristics of ischemic lesion in HPR patients were consistent with the following high-risk radiomic features associated with clinical symptoms: higher gray-level values, greater variance in intensity values, and greater homogeneity. However, the adjustment of antiplatelet therapy in HPR patients modified the high-risk radiomic features, which showed lower gray-level values, less variance in intensity values, and more heterogeneous texture. The radiomic shape feature of elongation showed no notable difference between three groups.
ConclusionAdjustment of antiplatelet therapy might reduce the high-risk radiomic features of UIA patients with HPR after stent placement.

背景：本研究旨在探讨支架置入术后伴未破裂颅内动脉瘤（unruptured intracranial aneurysms, UIA）的急性无症状性脑梗死（acute silent cerebral infarction, ASCI）患者中，治疗中血小板高反应性（high on-treatment platelet reactivity, HPR）与抗血小板治疗方案调整对高危放射组学特征的影响。
方法：本研究为单中心前瞻性研究，纳入2015年1月至2020年7月于我院接受支架置入术后发生ASCI的230例UIA患者。所有患者均于支架置入术后行弥散加权成像磁共振成像（magnetic resonance imaging with diffusion-weighted imaging, MRI-DWI）检查，并从每位患者的影像中提取1485个放射组学特征。采用最小绝对收缩和选择算子（least absolute shrinkage and selection operator, LASSO）回归法筛选与临床症状相关的高危放射组学特征。此外，将199例ASCI患者分为三组：无HPR对照组（n=113）、接受标准抗血小板治疗的HPR组（n=63）、接受抗血小板治疗方案调整的HPR组（n=23），并比较三组间的高危放射组学特征差异。
结果：在经MRI-DWI检出急性梗死灶的患者中，31例（13.5%）出现临床症状。最终筛选出8个与临床症状相关的高危放射组学特征，所构建的放射组学模型表现良好。在ASCI患者中，与无HPR对照组相比，HPR患者的缺血病灶放射组学特征符合以下与临床症状相关的高危特征：更高的灰度值、更大的信号强度方差以及更高的同质性。然而，对HPR患者实施抗血小板治疗方案调整后，其高危放射组学特征发生改变：灰度值更低、信号强度方差更小、纹理异质性更高。三组间的放射组学形状特征——伸长率均无显著差异。
结论：抗血小板治疗方案调整或可降低支架置入术后伴HPR的UIA患者的高危放射组学特征水平。