Human Brain Atlases in Stroke Management
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ORIGINAL ARTICLE
Human Brain Atlases in Stroke Management Wieslaw L. Nowinski 1
# The Author(s) 2020
Abstract Stroke is a leading cause of death and a major cause of permanent disability. Its management is demanding because of variety of protocols, imaging modalities, pulse sequences, hemodynamic maps, criteria for treatment, and time constraints to promptly evaluate and treat. To cope with some of these issues, we propose novel, patented solutions in stroke management by employing multiple brain atlases for diagnosis, treatment, and prediction. Numerous and diverse CT and MRI scans are used: ARIC cohort, ischemic and hemorrhagic stroke CT cases, MRI cases with multiple pulse sequences, and 128 stroke CT patients, each with 170 variables and one year follow-up. The method employs brain atlases of anatomy, blood supply territories, and probabilistic stroke atlas. It rapidly maps an atlas to scan and provides atlas-assisted scan processing. Atlas-to-scan mapping is application-dependent and handles three types of regions of interest (ROIs): atlas-defined ROIs, atlas-quantified ROIs, and ROIs creating an atlas. An ROI is defined by atlas-guided anatomy or scan-derived pathology. The atlas defines ROI or quantifies it. A brain atlas potential has been illustrated in four atlas-assisted applications for stroke occurrence prediction and screening, rapid and automatic stroke diagnosis in emergency room, quantitative decision support in thrombolysis in ischemic stroke, and stroke outcome prediction and treatment assessment. The use of brain atlases in stroke has many potential advantages, including rapid processing, automated and robust handling, wide range of applications, and quantitative assessment. Further work is needed to enhance the developed prototypes, clinically validate proposed solutions, and introduce them to clinical practice. Keywords Human brain atlas . Stroke . Neuroimaging . MR . CT . Neuroimage processing . Diagnosis . Treatment . Prediction . Prototype . Validation
Introduction Stroke is the most common life-threatening neurologic disorder. It is a leading cause of death and a major cause of permanent disability. Stroke has a profound effect on public health and generates huge costs for primary treatment, hospitalization, rehabilitation, and chronic care. Its management is demanding because of variety of protocols, imaging modalities, pulse sequences, hemodynamic maps, techniques and criteria for treatment, definitions of a mismatch and penumbra as well as time constraints to promptly evaluate, make decision and treat, among others (Mohr et al. 2004). Neuroinformatics and neuroimaging play a crucial role in stroke management. In order to make diagnosis and * Wieslaw L. Nowinski [email protected] 1
John Paul II Center for Virtual Anatomy and Surgical Simulation, University of Cardinal Stefan Wyszynski, Woycickiego 1/3, Block 12, room 1220, 01-938 Warsaw, Poland
therapeutic decision Computed Tomography (CT) and/or Magnetic Resonance (MR) imaging are used to: 1) differentiate stroke from non-str
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