Comparing Baseline and Day-1 Diffusion MRI Using Multimodal Deep Embeddings for Stroke Outcome Prediction
This work addresses stroke outcome prediction for acute ischemic stroke patients, but it is incremental as it applies existing methods to new data comparisons.
This study compared baseline and 24-hour diffusion MRI for predicting three-month functional outcomes after acute ischemic stroke, finding that day-1 multimodal models achieved the highest predictive performance with an AUC of 0.923, outperforming baseline models.
This study compares baseline (J0) and 24-hour (J1) diffusion magnetic resonance imaging (MRI) for predicting three-month functional outcomes after acute ischemic stroke (AIS). Seventy-four AIS patients with paired apparent diffusion coefficient (ADC) scans and clinical data were analyzed. Three-dimensional ResNet-50 embeddings were fused with structured clinical variables, reduced via principal component analysis (<=12 components), and classified using linear support vector machines with eight-fold stratified group cross-validation. J1 multimodal models achieved the highest predictive performance (AUC = 0.923 +/- 0.085), outperforming J0-based configurations (AUC <= 0.86). Incorporating lesion-volume features further improved model stability and interpretability. These findings demonstrate that early post-treatment diffusion MRI provides superior prognostic value to pre-treatment imaging and that combining MRI, clinical, and lesion-volume features produces a robust and interpretable framework for predicting three-month functional outcomes in AIS patients.