Deep Learning in the Prediction of Ischaemic Stroke Thrombolysis Functional Outcomes: A Pilot Study

Rationale and Objectives: Intravenous thrombolysis decision-making and obtaining of consent would be assisted by an individualized risk-benefit ratio. Deep learning (DL) models may be able to assist with this patient selection. Materials and Methods: Clinical data regarding consecutive patients who received intravenous thrombolysis across two tertiary hospitals over a 7-year period were extracted from existing databases. The noncontrast computed tomography brain scans for these patients were then retrieved with hospital picture archiving and communication systems. Using a combination of convolutional neural networks (CNN) and artificial neural networks (ANN) several models were developed to predict either improvement in the National Institutes of Health Stroke Scale of >= 4 points at 24 hours ("NIHSS24"), or modified Rankin Scale 0-1 at 90 days ("mRS90"). The developed CNN and ANN were then applied to a test set. The THRIVE, HIAT, and SPAN-100 scores were also calculated for the patients in the test set and used to predict NIHSS24 and mRS90. Results: Data from 204 individuals were included in the project. The best performing DL model for prediction of mRS90 was a combination CNN + ANN based on clinical data and computed tomography brain (accuracy = 0.74, F1 score = 0.69). The best performing model for NIHSS24 prediction was also the combination CNN + ANN (accuracy = 0.71, F1 score = 0.74). Conclusion: DL models may aid in the prediction of functional thrombolysis outcomes. Further investigation with larger datasets and additional imaging sequences is indicated.