2022
Deep Learning Applications for Acute Stroke Management
Chavva IR, Crawford AL, Mazurek MH, Yuen MM, Prabhat AM, Payabvash S, Sze G, Falcone GJ, Matouk CC, de Havenon A, Kim JA, Sharma R, Schiff SJ, Rosen MS, Kalpathy‐Cramer J, Gonzalez J, Kimberly WT, Sheth KN. Deep Learning Applications for Acute Stroke Management. Annals Of Neurology 2022, 92: 574-587. PMID: 35689531, DOI: 10.1002/ana.26435.Peer-Reviewed Original ResearchMeSH KeywordsDeep LearningHumansNeural Networks, ComputerNeuroimagingReproducibility of ResultsStrokeConceptsDeep machine learningDeep learning applicationsMedical image analysisDeep neural networksPixel-wise labelingAcute stroke managementReal-world examplesDL applicationsDL approachMachine learningLearning applicationsDL modelsNeural networkStroke managementLesion segmentationMaximal utilityImage analysisElectronic medical record dataInter-rater variabilityCause of disabilityMedical record dataRelevant clinical featuresStroke detectionAdvanced neuroimaging techniquesDecision makingBedside detection of intracranial midline shift using portable magnetic resonance imaging
Sheth KN, Yuen MM, Mazurek MH, Cahn BA, Prabhat AM, Salehi S, Shah JT, By S, Welch EB, Sofka M, Sacolick LI, Kim JA, Payabvash S, Falcone GJ, Gilmore EJ, Hwang DY, Matouk C, Gordon-Kundu B, RN AW, Petersen N, Schindler J, Gobeske KT, Sansing LH, Sze G, Rosen MS, Kimberly WT, Kundu P. Bedside detection of intracranial midline shift using portable magnetic resonance imaging. Scientific Reports 2022, 12: 67. PMID: 34996970, PMCID: PMC8742125, DOI: 10.1038/s41598-021-03892-7.Peer-Reviewed Original ResearchConceptsMidline shiftNeuroscience intensive care unitCare measurementYale-New Haven HospitalValuable bedside toolIntensive care unitPoor clinical outcomeBrain-injured patientsMass effectNew Haven HospitalMagnetic resonance imagingClinical outcomesIll patientsCare unitStroke patientsFunctional outcomeBedside toolObservational studyBedside detectionImaging examsPatientsResonance imagingPortable MRIImaging suiteSignificant concordance
2021
Early head CT in post-cardiac arrest patients: A helpful tool or contributor to self-fulfilling prophecy?
Beekman R, Maciel CB, Ormseth CH, Zhou SE, Galluzzo D, Miyares LC, Torres-Lopez VM, Payabvash S, Mak A, Greer DM, Gilmore EJ. Early head CT in post-cardiac arrest patients: A helpful tool or contributor to self-fulfilling prophecy? Resuscitation 2021, 165: 68-76. PMID: 34147572, DOI: 10.1016/j.resuscitation.2021.06.004.Peer-Reviewed Original ResearchMeSH KeywordsGray MatterHeart ArrestHumansPrognosisReproducibility of ResultsRetrospective StudiesTomography, X-Ray ComputedConceptsGray-white matter ratioHCT findingsArrest patientsInter-rater reliabilityPost-cardiac arrest patientsTertiary care academic medical centerEarly head CTPost-CA carePost-CA patientsCardiac arrest patientsHalf of casesAcademic medical centerElectronic medical recordsWithdrawal of lifeNeurophysiologic testingSpontaneous circulationInjury burdenMedical recordsHead CTTherapeutic decisionsMedical CenterPatientsNeurointensivistsHctTemperature management
2019
Multi-Institutional Validation of Deep Learning for Pretreatment Identification of Extranodal Extension in Head and Neck Squamous Cell Carcinoma.
Kann BH, Hicks DF, Payabvash S, Mahajan A, Du J, Gupta V, Park HS, Yu JB, Yarbrough WG, Burtness BA, Husain ZA, Aneja S. Multi-Institutional Validation of Deep Learning for Pretreatment Identification of Extranodal Extension in Head and Neck Squamous Cell Carcinoma. Journal Of Clinical Oncology 2019, 38: 1304-1311. PMID: 31815574, DOI: 10.1200/jco.19.02031.Peer-Reviewed Original ResearchConceptsNeck squamous cell carcinomaExtranodal extensionSquamous cell carcinomaLymph nodesCell carcinomaContrast-enhanced CT scanDiagnostic abilityBoard-certified neuroradiologistsTreatment escalationCancer Genome AtlasPathologic confirmationPretreatment identificationDiagnostic challengeExternal validation data setsPathology resultsPretreatment imagingPoor prognosticatorClinical utilityCT scanPatientsClinical decisionHNSCCDiagnostic accuracyInstitutional ValidationGenome Atlas
2017
Multivariate Prognostic Model of Acute Stroke Combining Admission Infarct Location and Symptom Severity: A Proof-of-Concept Study
Payabvash S, Benson JC, Tyan AE, Taleb S, McKinney AM. Multivariate Prognostic Model of Acute Stroke Combining Admission Infarct Location and Symptom Severity: A Proof-of-Concept Study. Journal Of Stroke And Cerebrovascular Diseases 2017, 27: 936-944. PMID: 29198948, DOI: 10.1016/j.jstrokecerebrovasdis.2017.10.034.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overArea Under CurveBrainBrain IschemiaBrain MappingDatabases, FactualDecision Support TechniquesDiffusion Magnetic Resonance ImagingDisability EvaluationFemaleHumansLogistic ModelsMaleMesencephalonMiddle AgedMultivariate AnalysisOdds RatioPatient AdmissionPonsPredictive Value of TestsProof of Concept StudyReproducibility of ResultsRetrospective StudiesRisk FactorsROC CurveSeverity of Illness IndexStrokeTime FactorsTreatment OutcomeConceptsDisability/deathMidbrain/ponsAcute ischemic stroke patientsIschemic stroke patientsAdmission NIHSS scoreStroke patientsNIHSS scoreIndependent predictorsInfarct locationScale scoreHealth Stroke Scale scoreHigher admission NIHSS scoresModified Rankin Scale scoreSymptom severityAdmission stroke severityBaseline functional disabilityLarger infarct volumesStroke Scale scoreRankin Scale scoreHours of onsetAcute ischemic infarctMultivariate prognostic modelMajor arterial occlusionHypothesis-generating studyVoxel-based analysis
2015
Comparison of CT perfusion summary maps to early diffusion-weighted images in suspected acute middle cerebral artery stroke
Benson J, Payabvash S, Salazar P, Jagadeesan B, Palmer CS, Truwit CL, McKinney AM. Comparison of CT perfusion summary maps to early diffusion-weighted images in suspected acute middle cerebral artery stroke. European Journal Of Radiology 2015, 84: 682-689. PMID: 25623829, DOI: 10.1016/j.ejrad.2014.12.026.Peer-Reviewed Original ResearchConceptsAlberta Stroke Program Early CT ScoreASPECTS scoreAcute middle cerebral artery strokeMiddle cerebral artery strokeAge-matched patientsDWI infarct volumeDiffusion-weighted imagingInfarct volumePositive patientsSymptom onsetArtery strokeCT scoreDiffusion-weighted imagesInfarct coreCTP examinationDWI volumePatientsDWIInfarctsScores
2013
Screening and detection of blunt vertebral artery injury in patients with upper cervical fractures: The role of cervical CT and CT angiography
Payabvash S, McKinney AM, McKinney ZJ, Palmer CS, Truwit CL. Screening and detection of blunt vertebral artery injury in patients with upper cervical fractures: The role of cervical CT and CT angiography. European Journal Of Radiology 2013, 83: 571-577. PMID: 24355656, DOI: 10.1016/j.ejrad.2013.11.020.Peer-Reviewed Original ResearchConceptsBlunt vertebral artery injuryVertebral artery injuryUpper cervical fracturesCervical fracturesSymptomatic strokeArtery injuryTrauma patientsBlunt trauma patientsPosterior circulation strokeScreening criteriaStrong interobserver agreementCervical CTCervical CTAUnderwent CTAClinical recordsNegative CTATransverse foramenCT angiographyCTA studiesClinical utilityPatientsInterobserver agreementC3-C7StrokeNECT
2012
Malignant CTA Collateral Profile Is Highly Specific for Large Admission DWI Infarct Core and Poor Outcome in Acute Stroke
Souza LC, Yoo AJ, Chaudhry ZA, Payabvash S, Kemmling A, Schaefer PW, Hirsch JA, Furie KL, González RG, Nogueira RG, Lev MH. Malignant CTA Collateral Profile Is Highly Specific for Large Admission DWI Infarct Core and Poor Outcome in Acute Stroke. American Journal Of Neuroradiology 2012, 33: 1331-1336. PMID: 22383238, PMCID: PMC3888794, DOI: 10.3174/ajnr.a2985.Peer-Reviewed Original ResearchConceptsDWI lesion volumeLesion volumeDWI volumeNIHSS scorePoor outcomeHigher median NIHSS scoresROC analysisDWI lesion sizeLarger DWI volumeMedian NIHSS scoreAcute stroke treatmentAdmission NIHSS scoreOnly independent predictorPoor functional outcomeIntracranial ICA occlusionCTA collateralsAcute strokeICA occlusionProximal occlusionIndependent predictorsStroke treatmentInfarct sizeClinical variablesFunctional outcomeInfarct core
2011
Cranial CT with Adaptive Statistical Iterative Reconstruction: Improved Image Quality with Concomitant Radiation Dose Reduction
Rapalino O, Kamalian S, Kamalian S, Payabvash S, Souza LC, Zhang D, Mukta J, Sahani DV, Lev MH, Pomerantz SR. Cranial CT with Adaptive Statistical Iterative Reconstruction: Improved Image Quality with Concomitant Radiation Dose Reduction. American Journal Of Neuroradiology 2011, 33: 609-615. PMID: 22207302, PMCID: PMC8050448, DOI: 10.3174/ajnr.a2826.Peer-Reviewed Original ResearchConceptsHead CTRadiation dose reductionAdult head CTBlinded qualitative analysisHigh-dose onesUse of ASIRCT radiation dose reductionASIR levelsHounsfield unit measurementsAdult patientsLow-dose scansBrain parenchymaCranial CTRoutine doseLow radiation dosesDose reductionCT scanLow-dose CT datasetAdaptive statistical iterative reconstructionPatient healthASIR reconstructionNormal GMsCTDose scansGM-WM differentiationCT Perfusion Mean Transit Time Maps Optimally Distinguish Benign Oligemia from True “At-Risk” Ischemic Penumbra, but Thresholds Vary by Postprocessing Technique
Kamalian S, Kamalian S, Konstas AA, Maas MB, Payabvash S, Pomerantz SR, Schaefer PW, Furie KL, González RG, Lev MH. CT Perfusion Mean Transit Time Maps Optimally Distinguish Benign Oligemia from True “At-Risk” Ischemic Penumbra, but Thresholds Vary by Postprocessing Technique. American Journal Of Neuroradiology 2011, 33: 545-549. PMID: 22194372, PMCID: PMC3746025, DOI: 10.3174/ajnr.a2809.Peer-Reviewed Original ResearchConceptsAcute stroke patientsLarge vessel occlusionBenign oligemiaStroke patientsIschemic penumbraCTP parametersRelative cerebral blood flowConsecutive stroke patientsHours of onsetCerebral blood flowMean transit time mapsCharacteristic curve analysisTransit time mapsUninvolved hemisphereRadiographic evidenceThrombolytic therapyFinal infarctVessel occlusionRelative MTTBlood flowCTP mapsPerfusion parametersOligemiaReperfusionPatientsCT Cerebral Blood Flow Maps Optimally Correlate With Admission Diffusion-Weighted Imaging in Acute Stroke but Thresholds Vary by Postprocessing Platform
Kamalian S, Kamalian S, Maas MB, Goldmacher GV, Payabvash S, Akbar A, Schaefer PW, Furie KL, Gonzalez RG, Lev MH. CT Cerebral Blood Flow Maps Optimally Correlate With Admission Diffusion-Weighted Imaging in Acute Stroke but Thresholds Vary by Postprocessing Platform. Stroke 2011, 42: 1923-1928. PMID: 21546490, PMCID: PMC3125441, DOI: 10.1161/strokeaha.110.610618.Peer-Reviewed Original ResearchConceptsDiffusion-weighted imagingCT perfusion parametersAcute strokeCT perfusionInfarct coreAdmission diffusion-weighted imagingPerfusion parametersCerebral blood flowCerebral blood flow mapsCerebral blood volumeCharacteristic curve analysisAdmission CT perfusionBlood flow mapsUninvolved hemisphere
2010
Predicting Language Improvement in Acute Stroke Patients Presenting with Aphasia: A Multivariate Logistic Model Using Location-Weighted Atlas-Based Analysis of Admission CT Perfusion Scans
Payabvash S, Kamalian S, Fung S, Wang Y, Passanese J, Kamalian S, Souza LC, Kemmling A, Harris GJ, Halpern EF, González RG, Furie KL, Lev MH. Predicting Language Improvement in Acute Stroke Patients Presenting with Aphasia: A Multivariate Logistic Model Using Location-Weighted Atlas-Based Analysis of Admission CT Perfusion Scans. American Journal Of Neuroradiology 2010, 31: 1661-1668. PMID: 20488905, PMCID: PMC3640318, DOI: 10.3174/ajnr.a2125.Peer-Reviewed Original ResearchMeSH KeywordsAlgorithmsAphasiaBrainComputer SimulationFemaleHumansLogistic ModelsMaleModels, NeurologicalMultivariate AnalysisPattern Recognition, AutomatedPerfusion ImagingPrognosisRadiographic Image Interpretation, Computer-AssistedReproducibility of ResultsSensitivity and SpecificityStrokeSubtraction TechniqueTomography, X-Ray ComputedConceptsBrain CTPNIHSS scoreStroke onsetFunctional outcomeFirst-time ischemic strokeProximal cerebral artery occlusionMultiple logistic regression analysisMultivariate logistic regression modelMultivariate modelDischarge NIHSS scoreTotal NIHSS scoreAcute stroke patientsCerebral artery occlusionTime of dischargeCT perfusion imagingLogistic regression analysisMultivariate logistic modelCT perfusion scansLogistic regression modelsAdmission CTAArtery occlusionInfarct volumeIschemic strokeClinical predictorsConsecutive patients