Diagnostic Models for Differentiating COVID-19-Related Acute Ischemic Stroke Using Machine Learning Methods

<b>Backgrounds:</b> Although COVID-19 is primarily known as a respiratory disease, there is growing evidence of neurological complications, such as ischemic stroke, in infected individuals. This study aims to evaluate the impact of COVID-19 on acute ischemic stroke (AIS) using radiomic f...

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Main Authors: Eylem Gul Ates, Gokcen Coban, Jale Karakaya
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/14/24/2802
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author Eylem Gul Ates
Gokcen Coban
Jale Karakaya
author_facet Eylem Gul Ates
Gokcen Coban
Jale Karakaya
author_sort Eylem Gul Ates
collection DOAJ
description <b>Backgrounds:</b> Although COVID-19 is primarily known as a respiratory disease, there is growing evidence of neurological complications, such as ischemic stroke, in infected individuals. This study aims to evaluate the impact of COVID-19 on acute ischemic stroke (AIS) using radiomic features extracted from brain MR images and machine learning methods. <b>Methods:</b> This retrospective study included MRI data from 57 patients diagnosed with AIS who presented to the Department of Radiology at Hacettepe University Hospital between March 2020 and September 2021. Patients were stratified into COVID-19-positive (<i>n</i> = 30) and COVID-19-negative (<i>n</i> = 27) groups based on PCR results. Radiomic features were extracted from brain MR images following image processing steps. Various feature selection algorithms were applied to identify the most relevant features, which were then used to train and evaluate machine learning classification models. Model performance was evaluated using a range of classification metrics, including measures of predictive accuracy and diagnostic reliability, with 95% confidence intervals provided to enhance reliability. <b>Results:</b> This study assessed the performance of dimensionality reduction and classification algorithms in distinguishing COVID-19-negative and COVID-19-positive cases using radiomics data from brain MR scans. Without feature selection, ANN achieved the highest AUC of 0.857 (95% CI: 0.806–0.900), demonstrating strong discriminative power. Using the Boruta method for feature selection, the k-NN classifier attained the best performance, with an AUC of 0.863 (95% CI: 0.816–0.904). LASSO-based feature selection showed comparable results across k-NN, RF, and ANN classifiers, while SVM exhibited excellent specificity and high PPV. The RFE method yielded the highest overall performance, with the k-NN classifier achieving an AUC of 0.882 (95% CI: 0.838–0.924) and an accuracy of 79.1% (95% CI: 73.6–83.8). Among the methods, RFE provided the most consistent results, with k-NN and the ANN identified as the most effective classifiers for COVID-19 detection. <b>Conclusions:</b> The proposed radiomics-based classification model effectively distinguishes AIS associated with COVID-19 from brain MRI. These findings demonstrate the potential of AI-driven diagnostic tools to identify high-risk patients, support optimized treatment strategies, and ultimately improve clinical implications.
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spelling doaj-art-e1a243a997654ea9a6dfd49ffb92d29b2024-12-27T14:20:47ZengMDPI AGDiagnostics2075-44182024-12-011424280210.3390/diagnostics14242802Diagnostic Models for Differentiating COVID-19-Related Acute Ischemic Stroke Using Machine Learning MethodsEylem Gul Ates0Gokcen Coban1Jale Karakaya2Institutional Big Data Management Coordination Office, Middle East Technical University, 06800 Ankara, TürkiyeDepartment of Radiology, Hacettepe University, 06230 Ankara, TürkiyeDepartment of Biostatistics, Hacettepe University, 06230 Ankara, Türkiye<b>Backgrounds:</b> Although COVID-19 is primarily known as a respiratory disease, there is growing evidence of neurological complications, such as ischemic stroke, in infected individuals. This study aims to evaluate the impact of COVID-19 on acute ischemic stroke (AIS) using radiomic features extracted from brain MR images and machine learning methods. <b>Methods:</b> This retrospective study included MRI data from 57 patients diagnosed with AIS who presented to the Department of Radiology at Hacettepe University Hospital between March 2020 and September 2021. Patients were stratified into COVID-19-positive (<i>n</i> = 30) and COVID-19-negative (<i>n</i> = 27) groups based on PCR results. Radiomic features were extracted from brain MR images following image processing steps. Various feature selection algorithms were applied to identify the most relevant features, which were then used to train and evaluate machine learning classification models. Model performance was evaluated using a range of classification metrics, including measures of predictive accuracy and diagnostic reliability, with 95% confidence intervals provided to enhance reliability. <b>Results:</b> This study assessed the performance of dimensionality reduction and classification algorithms in distinguishing COVID-19-negative and COVID-19-positive cases using radiomics data from brain MR scans. Without feature selection, ANN achieved the highest AUC of 0.857 (95% CI: 0.806–0.900), demonstrating strong discriminative power. Using the Boruta method for feature selection, the k-NN classifier attained the best performance, with an AUC of 0.863 (95% CI: 0.816–0.904). LASSO-based feature selection showed comparable results across k-NN, RF, and ANN classifiers, while SVM exhibited excellent specificity and high PPV. The RFE method yielded the highest overall performance, with the k-NN classifier achieving an AUC of 0.882 (95% CI: 0.838–0.924) and an accuracy of 79.1% (95% CI: 73.6–83.8). Among the methods, RFE provided the most consistent results, with k-NN and the ANN identified as the most effective classifiers for COVID-19 detection. <b>Conclusions:</b> The proposed radiomics-based classification model effectively distinguishes AIS associated with COVID-19 from brain MRI. These findings demonstrate the potential of AI-driven diagnostic tools to identify high-risk patients, support optimized treatment strategies, and ultimately improve clinical implications.https://www.mdpi.com/2075-4418/14/24/2802image processingmachine learningCOVID-19long COVID-19strokeacute ischemia
spellingShingle Eylem Gul Ates
Gokcen Coban
Jale Karakaya
Diagnostic Models for Differentiating COVID-19-Related Acute Ischemic Stroke Using Machine Learning Methods
Diagnostics
image processing
machine learning
COVID-19
long COVID-19
stroke
acute ischemia
title Diagnostic Models for Differentiating COVID-19-Related Acute Ischemic Stroke Using Machine Learning Methods
title_full Diagnostic Models for Differentiating COVID-19-Related Acute Ischemic Stroke Using Machine Learning Methods
title_fullStr Diagnostic Models for Differentiating COVID-19-Related Acute Ischemic Stroke Using Machine Learning Methods
title_full_unstemmed Diagnostic Models for Differentiating COVID-19-Related Acute Ischemic Stroke Using Machine Learning Methods
title_short Diagnostic Models for Differentiating COVID-19-Related Acute Ischemic Stroke Using Machine Learning Methods
title_sort diagnostic models for differentiating covid 19 related acute ischemic stroke using machine learning methods
topic image processing
machine learning
COVID-19
long COVID-19
stroke
acute ischemia
url https://www.mdpi.com/2075-4418/14/24/2802
work_keys_str_mv AT eylemgulates diagnosticmodelsfordifferentiatingcovid19relatedacuteischemicstrokeusingmachinelearningmethods
AT gokcencoban diagnosticmodelsfordifferentiatingcovid19relatedacuteischemicstrokeusingmachinelearningmethods
AT jalekarakaya diagnosticmodelsfordifferentiatingcovid19relatedacuteischemicstrokeusingmachinelearningmethods