Clot Analog Attenuation in Non-contrast CT Predicts Histology: an Experimental Study Using Machine Learning

González, Aglaé Velasco; Buerke, Boris; Görlich, Dennis; Fobker, Manfred; Rusche, Thilo; Sauerland, Cristina; Meier, Norbert; Jeibmann, Astrid; McCarthy, Ray; Kugel, Harald; Sporns, Peter; Faldum, Andreas; Paulus, Werner; Heindel, Walter

doi:10.1007/s12975-019-00766-z

Cited by 18 publications

(30 citation statements)

References 34 publications

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“…Previous studies have successfully created blood clot analogs for in vitro testing using animal blood of various species, which have significantly advanced our understanding of clot biomechanics and imaging characteristics. [13][14][15][16][17][18][19] However, blood components and blood groups vary among species; 20 thus, creating clot analogs with human blood is likely a more accurate representation of thrombi formed in the human vasculature.…”

Section: Resultsmentioning

confidence: 99%

Novel Human Acute Ischemic Stroke Blood Clot Analogs for In Vitro Thrombectomy Testing

Fitzgerald¹,

Liu²,

Dai³

et al. 2021

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Previous studies have successfully created blood clot analogs for in vitro endovascular device testing using animal blood of various species. Blood components vary greatly among species; therefore, creating clot analogs from human blood is likely a more accurate representation of thrombi formed in the human vasculature. MATERIALS AND METHODS:Following approval from the Mayo Clinic institutional review board, human whole-blood and platelet donations were obtained from the blood transfusion service. Twelve clot analogs were created by combining different ratios of red blood cells 1 buffy coat, plasma, and platelets. Thrombin and calcium chloride were added to stimulate coagulation. Clot composition was assessed using histologic and immunohistochemical staining. To assess the similarities of mechanical properties to patient clots, 3 types of clot analogs (soft, elastic, and stiff) were selected for in vitro thrombectomy testing.

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Section: Resultsmentioning

confidence: 99%

Novel Human Acute Ischemic Stroke Blood Clot Analogs for In Vitro Thrombectomy Testing

Fitzgerald¹,

Liu²,

Dai³

et al. 2021

AJNR Am J Neuroradiol

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“…A high lipid-rich composition might explain this preliminary observation but requires further exploration in larger sample-sized studies. Thrombus attenuation depends on the hematocrit and components such as cellular debris and lipids [15][16][17]. Furthermore, septic components of thrombi may influence the attenuation of thrombi [18].…”

Section: Discussionmentioning

confidence: 99%

Utility of Hounsfield unit in the diagnosis of tandem occlusion in acute ischemic stroke

et al. 2020

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Background Tandem occlusions can complicate medical and endovascular stroke treatment. To identify these occlusions, computed tomography angiography (CTA) represents the best imaging modality. However, CTA is still not initially performed in some patients not admitted directly to stroke centers. Early identification of an additional occlusion of the proximal extracranial internal carotid artery may improve the best suitable treatment strategy. The purpose of this study was to find a valuable threshold of thrombus attenuation in a non-contrast head CT (NCCT) scan to facilitate a safe diagnosis of tandem occlusions. Materials and methods Consecutive patients with acute middle cerebral artery (MCA) occlusions who underwent endovascular treatment were identified from our registry of neuroendovascular interventions. Thrombus attenuations of the affected MCA and contralateral vessel were measured by NCCT. To compare individual baseline blood attenuations, the difference between the thrombus attenuation and the contralateral MCA attenuation (referred to as ΔTM) was calculated. Results Three hundred and twenty-five patients were included. There was a highly significant difference between mean thrombus attenuation with isolated MCA occlusion and additional extracranial internal carotid artery (ICA) occlusion (49.9 ± 8 vs. 56.2 ± 10 Hounsfield units (HU); P < 0.001). The area under the receiver operating characteristic curve of ΔTM was 0.72. The optimal threshold value was 13.5 HU, with a sensitivity of 67.5% and a specificity of 68.6%. Conclusion Despite a significant difference in thrombus attenuation in MCA occlusions with an additional extracranial ICA occlusion compared with isolated MCA occlusions, a relevant threshold of thrombus attenuation was not found.

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“…Student interaction with radiologists and clinicians should be supported to generate teaching and learning in radiology and the specialities involved, by actively engaging students in radiology topics during multidisciplinary discussions (Collins, 2007;Pagani & Morin, 2020;Petsch et al, 2020b). Students should be integrated in assisting senior consultant radiologists in effective preparation and follow-up of case demonstrations for MCs to become familiar with radiological imaging and neuroradiological interventions (Petsch et al, 2020a;Velasco González , et al, 2020). Students should be guided in routine tasks and procedures in radiology (Visscher et al, 2015;Dettmer et al, 2017), and in understanding case demonstrations (Slanetz, 2011;Rahim & Ros, 2016;Petsch et al, 2020a).…”

Section: 3overall Discussionmentioning

confidence: 99%

“…If learning benefits are expressed from only passive yet frequent attendance, this indicates that senior consultant radiologists and specialists should enhance open-minded and flexible student engagement in case analysis and clinical discussions (Collins, 2009;Haupt & Antonites, 2020;Pagani & Morin, 2020). By increasing student integration, welcoming questions on clinical explanations, radiological procedures and therapies in radiological and neuroradiological interventions (Gunderman et al, 2003;Velasco González et al, 2020), we signalise support of student development of self-initiative and responsibility in gaining medical knowledge in radiology (Newman & Peile, 2002;McLeod & Steinert, 2015;Petsch et al, 2020b). We agree that radiology education should be made more present and interactive in the big picture of medical education (Gunderman & Hafeez, 2010;Rahim & Ros, 2016), since radiology has an interface function interacting with all medical disciplines (Gunderman et al, 2003;Munk, 2016).…”

Section: 2teaching and Learning Processesmentioning

confidence: 96%

Exploiting Multidisciplinary Conferences in Radiology: Teaching and Learning Opportunities for Medical Students, Radiologists and Clinicians

Petsch

González

Buerke

2020

EJTE

Self Cite

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Multidisciplinary conferences (MCs) including tumor boards (TBs) holding teaching and learning opportunities for medical knowledge should be exploited as educational settings for medical students in radiology. A total of 108 MCs in radiology were analysed on interaction among students, radiologists and clinicians by non-participatory observation in 2019. Data were documented with a standardised observation sheet on criteria of teaching and learning interaction, then categorised and coded. The qualitative analysis was outlined based on two modified pedagogical principles of proactive learning, and teaching and learning processes. Results show that medical students join MCs on their own initiative. However, participation is passive. Interaction with radiologists and clinicians is limited. Although radiologists encourage students to join clinical discussions, to ask questions, and to assist in preparation of case demonstrations, students rarely seize the opportunity. The paper concludes that student interaction with radiologists and clinicians is limited regarding radiology and other medical disciplines. Students should be engaged in clinical discussions; be integrated in assisting radiologists in preparation and follow-up of case demonstrations to learn about imaging; be guided in case demonstrations to understand that clinical decisions depend on information in imaging. MCs can be exploited for teaching and proactive learning by students, radiologists and clinicians. Keywords: multidisciplinary conferences, teaching opportunities, medical education, academic radiology, student interaction

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Clot Analog Attenuation in Non-contrast CT Predicts Histology: an Experimental Study Using Machine Learning

Cited by 18 publications

References 34 publications

Novel Human Acute Ischemic Stroke Blood Clot Analogs for In Vitro Thrombectomy Testing

Novel Human Acute Ischemic Stroke Blood Clot Analogs for In Vitro Thrombectomy Testing

Utility of Hounsfield unit in the diagnosis of tandem occlusion in acute ischemic stroke

Exploiting Multidisciplinary Conferences in Radiology: Teaching and Learning Opportunities for Medical Students, Radiologists and Clinicians

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