Nomogram to predict 1-year cognitive decline after stent placement for unruptured intracranial aneurysms
Wenqiang Li,
Chao Wang,
Yuzhao Lu,
Junfan Chen,
Wenbin Li,
Yunpeng Liu,
Ziqing Zhang,
Zeping Jin,
Yiqi Liu,
Song Tan,
Zhiwei Zhang,
Xiaofei Huang,
Cong Ding,
Linfeng Zhang,
Jian Liu,
David M. Hasan,
Yang Wang
Affiliations
Wenqiang Li
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Chao Wang
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Yuzhao Lu
Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
Junfan Chen
Department of Interventional Neuroradiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
Wenbin Li
Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
Yunpeng Liu
Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
Ziqing Zhang
Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
Zeping Jin
Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
Yiqi Liu
Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
Song Tan
Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
Zhiwei Zhang
SingularityFlow Co. Ltd., Beijing, China
Xiaofei Huang
Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
Cong Ding
Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
Linfeng Zhang
Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
Jian Liu
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
David M. Hasan
Department of Neurosurgery, Duke University, Durham, NC, USA
Yang Wang
Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China; Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Corresponding author
Summary: New iatrogenic cerebral infarcts (NICIs) are common findings on diffusion-weighted magnetic resonance imaging (DWI) following stent placement for unruptured intracranial aneurysms (UIAs) and may contribute to cognitive decline (CD). Using posttreatment DWI and clinical features, we developed a deep learning radiomics nomogram (DLRN) to predict 1-year CD in NICI patients. In a multicenter cohort of 526 patients, CD rates at 1 year were 18.7% (47/251) in the training cohort, 19.8% (33/167) in the external validation cohort, and 20.4% (22/108) in the prospective cohort. The DLRN achieved excellent predictive performance with areas under the curve of 0.975, 0.942, and 0.841 for the respective cohorts. Calibration and decision curve analyses confirmed its reliability and clinical utility. This tool could facilitate early identification of high-risk patients, enabling timely, and tailored interventions to protect cognitive function.
