开发和验证临床成像机器学习和深度学习模型,以预测患者对初始抗药物的反应
Mohammad-Reza Nazem-Zadeh1,2, Richard Shek-Kwan Chang1,3, Sarah Barnard1
1Department of Neuroscience, School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
Epilepsia
|October 24, 2025
概括
使用脑MRI和临床数据的人工智能模型可以高准确度地预测发作自由度. 这些人工智能工具可能会改善患者的治疗选择.
科学领域:
- 神经学 神经学
- 医疗成像医学成像
- 人工智能的人工智能
背景情况:
- 抗发作药物 (ASM) 是第一线治疗方法,但对约40%的患者是无效的.
- 对ASM的个体反应是不可预测的,需要更好的治疗选择策略.
研究的目的:
- 开发和验证人工智能 (AI) 模型,用于预测患者对前两种ASM的反应.
- 整合临床数据和脑磁共振成像 (MRI) 以提高预测准确度.
主要方法:
- 使用临床特征,ASM和多式脑MRI数据开发AI模型.
- 采用融合深度学习 (DL) 模型,结合3D视频ResNet,变压器编码器和双线性神经网络.
- 使用五倍交叉内部验证和来自人类项目外部队列的验证模型.
主要成果:
- 融合DL模型在内部交叉验证中获得了0.75±0.05的F1得分.
- 这种DL模型在外部验证队列 (p < 0.001) 上明显优于最佳机器学习 (ML) 模型.
- 该模型整合了多序MRI数据,ASM方案和临床特征以进行预测.
结论:
- 结合脑部MRI,临床和药物数据的AI模型可以预测近期发作的发作自由度.
- 这些人工智能工具显示出改善治疗选择和告知临床决策支持系统的潜力.
- 建议在更大的患者队伍中进一步验证以确认疗效.
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