Henk A Marquering

Henk A Marquering
Academisch Medisch Centrum Universiteit van Amsterdam | AMC · Department of Radiology and Nuclear Medicine / Department of Biomedical Engineering and Physics

PhD

About

319
Publications
46,150
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11,536
Citations
Additional affiliations
September 2010 - present
Academisch Medisch Centrum Universiteit van Amsterdam
Position
  • Research Assistant
September 2009 - present
Academisch Medisch Centrum Universiteit van Amsterdam
Position
  • Professor (Assistant)
September 2009 - present
University of Amsterdam
Position
  • Research Assistant

Publications

Publications (319)
Article
Background and objective Computed tomography perfusion (CTP) is widely used in the evaluation of acute ischemic stroke patients for endovascular thrombectomy (EVT). The stability of CTP core estimation is suboptimal and varies between software packages. We aimed to quantify the volumetric and spatial agreement between the CTP ischemic core and foll...
Article
Background: Thrombus radiomics (TR) describe complex shape and textural thrombus imaging features. We aimed to study the relationship of TR extracted from non-contrast CT with procedural and functional outcome in endovascular-treated patients with acute ischemic stroke. Methods: Thrombi were segmented on thin-slice non-contrast CT (≤1 mm) from 6...
Article
Background The effects of thrombus imaging characteristics on procedural and clinical outcomes after ischemic stroke are increasingly being studied. These thrombus characteristics – for eg, size, location, and density – are commonly analyzed as separate entities. However, it is known that some of these thrombus characteristics are strongly related....
Article
Purpose Onset to imaging (OTI) time is a crucial factor in determining treatment eligibility for acute ischemic stroke patients, since the treatments are time-dependent. Patients with an unknown OTI time are often excluded from treatment, or advanced imaging is needed, which is not widely and readily available. As non-contrast CT (NCCT) is part of...
Article
Full-text available
Thrombus volume in posterior circulation stroke (PCS) has been associated with outcome, through recanalization. Manual thrombus segmentation is impractical for large scale analysis of image characteristics. Hence, in this study we develop the first automatic method for thrombus localization and segmentation on CT in patients with PCS. In this multi...
Preprint
BACKGROUND Acute stroke care demands fast procedures carried out through the collaboration of multiple professionals across multiple organisations. Cloud computing and the wide adoption of electronic medical records (EMR) enable healthcare systems to improve data availability and facilitate sharing among professionals. However, designing a secure a...
Poster
Background: A DPP6 gene risk haplotype, putatively enhancing Purkinje fiber transient outward current I to , associates with familial idiopathic ventricular fibrillation (IVF). Outside this genetic disposition, no clinical risk factors nor ECG features for IVF have so far been identified to recognize those at risk for IVF. Objective: We aimed to de...
Article
Full-text available
Purpose We aimed to study the association of non-contrast CT (NCCT) thrombus density with procedural and clinical outcomes in patients with acute ischemic stroke who underwent endovascular treatment (EVT). Since thrombus density is associated with thrombus location, we focused on M1 occlusions only. Methods Patients with available thin-slice (< 2....
Article
Objectives: Thrombus computed tomography (CT) characteristics might be used to assess histopathologic thrombus composition in patients treated with endovascular thrombectomy (EVT) for acute ischemic stroke (AIS). We aimed to assess the variability in thrombus composition that could be predicted with combined thrombus CT characteristics. Methods:...
Article
BACKGROUND Current American guidelines are uncertain regarding endovascular treatment (EVT) for patients with acute ischemic stroke with an Alberta Stroke Program Early Computed Tomography Score (ASPECTS) <6. Dutch guidelines do not specify ASPECTS‐based exclusion criteria for EVT. In this retrospective observational cohort study, we investigated o...
Article
Full-text available
Introduction Computed tomography perfusion (CTP) is variably considered to assess eligibility for endovascular thrombectomy (EVT) in acute ischemic (AIS) stroke patients. Although CTP is recommended for patient selection in later (6–24 h) time window, it is currently not recommended in the earlier (0–6 h) time window and the costs and health effect...
Article
BACKGROUND Fast and accurate detection of large vessel occlusions (LVOs) is crucial in selection of patients with acute ischemic stroke for endovascular treatment. We assessed accuracy of an automated LVO detection algorithm with LVO localization feature. METHODS Consecutive patients who underwent computed tomography angiography in 2 centers betwe...
Article
BACKGROUND Contrary to anterior circulation stroke, studies on the association between thrombus imaging characteristics and outcomes are scarce in patients with posterior circulation stroke (PCS). We aimed to investigate the association of thrombus imaging characteristics with reperfusion and functional outcome in patients with PCS who underwent en...
Article
Full-text available
Background Prehospital detection of large vessel occlusion stroke of the anterior circulation (LVO-a) would enable direct transportation of these patients to an endovascular thrombectomy (EVT) capable hospital. The ongoing ELECTRA-STROKE study investigates the diagnostic accuracy of dry electrode electroencephalography (EEG) for LVO-a stroke in the...
Article
Full-text available
Background Accurate prediction of clinical outcome is of utmost importance for choices regarding the endovascular treatment (EVT) of acute stroke. Recent studies on the prediction modeling for stroke focused mostly on clinical characteristics and radiological scores available at baseline. Radiological images are composed of millions of voxels, and...
Article
Objectives: To compare single parameter thresholding with multivariable probabilistic classification of ischemic stroke regions in the analysis of computed tomography perfusion (CTP) parameter maps. Methods: Patients were included from two multicenter trials and were divided into two groups based on their modified arterial occlusive lesion grade...
Article
Background A thrombus in the M1 segment of the middle cerebral artery (MCA) can occlude this main stem only or extend into the M1-M2 bifurcation. The occlusion pattern may affect endovascular treatment (EVT) success, as a bifurcated thrombus may be more prone to fragmentation during retrieval. Objective To investigate whether bifurcated thrombus p...
Article
Full-text available
Purpose Follow-up infarct volume (FIV) is moderately associated with functional outcome. We hypothesized that accounting for infarct location would strengthen the association of FIV with functional outcome. Methods We included 252 patients from the HERMES collaboration with follow-up diffusion weighted imaging. Patients received endovascular treat...
Article
Introduction: Vascular anatomy might affect endovascular treatment success in acute ischemic stroke patients with large vessel occlusion. We investigated the prognostic value of extracranial vascular characteristics on procedural time and revascularization success in patients with large vessel occlusion in the anterior cerebral circulation. Patie...
Article
Background: Cardiac thrombi are a major risk factor for ischemic stroke. We used cardiac CT to assess the prevalence of cardiac thrombi in acute ischemic stroke patients. Methods: This was a substudy of Mind the Heart, a prospective single-center cohort study in which consecutive adult patients with acute ischemic stroke underwent prospective ECG-g...
Article
Background: In patients with ischemic stroke undergoing endovascular treatment (EVT), time to treatment and collateral status are important prognostic factors. We assessed the relation between time to CT angiography (CTA) and collateral status. Furthermore, we assessed whether collateral status modifies the relationship between onset to recanalizat...
Article
Summary Purpose : Mechanical thrombectomies (MT) in patients with large vessel occlusion (LVO) related to calcified cerebral embolus (CCE) have been reported, through small case series, being associated with low reperfusion rate and worse outcome, compared to regular MT. The purpose of the MASC (Mechanical Thrombectomy in Acute Ischemic Stroke Rela...
Article
Background Higher expanded Treatment In Cerebral Ischemia (eTICI) reperfusion scores after endovascular treatment (EVT) are associated with better outcomes. However, the influence of the number of passes on this association is unclear. We aimed to compare outcomes of single-pass good reperfusion (eTICI 2B) with multiple-pass excellent/complete repe...
Article
Full-text available
Background: A considerable proportion of acute ischemic stroke patients treated with endovascular thrombectomy (EVT) are dead or severely disabled at 3 months despite successful reperfusion. Ischemic core imaging biomarkers may help to identify patients who are more likely to have a poor outcome after endovascular thrombectomy (EVT) despite success...
Article
Full-text available
Development of in silico models of patient-specific cerebral artery networks presents several significant technical challenges: (i) The resolution and smoothness of medical CT images are much lower than the required element/cell length for FEA/CFD/FSI models; (ii) contact between vessels, and indeed self contact of high tortuosity vessel segments a...
Article
Full-text available
Background: Machine learning models have been developed for numerous medical prognostic purposes. These models are commonly developed using data from single centers or regional registries. Including data from multiple centers improves robustness and accuracy of prognostic models. However, data sharing between multiple centers is complex, mainly bec...
Article
Background and objectives: Transfer learning is a valuable approach to perform medical image segmentation in settings with limited cases available for training convolutional neural networks (CNN). Both the source task and the source domain influence transfer learning performance on a given target medical image segmentation task. This study aims to...
Article
Objective: For accurate risk assessment of unruptured intracranial aneurysms, it is important to understand the underlying mechanisms that lead to rupture. It is known that hemodynamic anomalies contribute to aneurysm growth and rupture, and that growing aneurysms carry higher rupture risks. However, it is unknown how growth affects hemodynamic ch...
Article
Background and Purpose Endovascular treatment for acute ischemic stroke has been proven clinically effective, but evidence of the cost-effectiveness based on real-world data is scarce. The aim of this study was to assess whether endovascular therapy plus usual care is cost-effective in comparison to usual care alone in acute ischemic stroke patient...
Article
Background and Purpose Blinded outcome assessment in trials with prospective randomized open blinded end point design is challenging. Unblinding can result in misclassified outcomes and biased treatment effect estimates. An outcome adjudication committee assures blinded outcome assessment, but the added value for trials with prospective randomized...
Article
Thrombus composition and mechanical properties significantly impact the procedural ease and outcomes of thrombectomy procedures in patients with acute ischemic stroke. A wide variation exists in the histological properties of thrombi between patients. If a relationship can be determined between the histological composition of a thrombus and its mec...
Article
Background and Purpose Computed tomography perfusion imaging allows estimation of tissue status in patients with acute ischemic stroke. We aimed to improve prediction of the final infarct and individual infarct growth rates using a deep learning approach. Methods We trained a deep neural network to predict the final infarct volume in patients with...
Article
Full-text available
Thoracoscopic surgical ablation (SA) for atrial fibrillation (AF) has shown to be an effective treatment to restore sinus rhythm in patients with advanced AF. Identifying patients who will not benefit from this procedure would be valuable to improve personalized AF therapy. Machine learning (ML) techniques may assist in the improvement of clinical...
Article
Full-text available
Residual blood flow distal to an arterial occlusion in patients with acute ischemic stroke (AIS) is associated with favorable patient outcome. Both collateral flow and thrombus permeability may contribute to such residual flow. We propose a method for discriminating between these two mechanisms, based on determining the direction of flow in multipl...
Article
Full-text available
Final lesion volume (FLV) is a surrogate outcome measure in anterior circulation stroke (ACS). In posterior circulation stroke (PCS), this relation is plausibly understudied due to a lack of methods that automatically quantify FLV. The applicability of deep learning approaches to PCS is limited due to its lower incidence compared to ACS. We evaluat...
Article
There is a discrepancy between successful recanalization and good clinical outcome after endovascular treatment (EVT) in acute ischemic stroke patients. During removal of a thrombus, a shower of microemboli may release and lodge to the distal circulation. The objective of this study was to determine the extent of damage on brain tissue caused by mi...
Article
Full-text available
The aim of this work is to propose a methodology for identifying relationships between morphological features of the cerebral vasculature and the outcome of in silico simulations of thrombectomy, the mechanical treatment for acute ischemic stroke. Fourteen patient-specific cerebral vasculature segmentations were collected and used for geometric cha...
Article
Thrombus perviousness is strongly associated with functional outcome and intravenous alteplase treatment success in patients with acute ischemic stroke. Accuracy of thrombus attenuation increase (TAI) assessment may be compromised by a heterogeneous thrombus composition and interobserver variations of currently used manual measurements. We hypothes...
Article
An in silico trial simulates a disease and its corresponding therapies on a cohort of virtual patients to support the development and evaluation of medical devices, drugs and treatment. in silico trials have the potential to refine, reduce cost, and partially replace current in vivo studies, namely clinical trials and animal testing. We present the...
Article
Background and purpose: Ischemic lesion volume can increase even 24 hours after onset of an acute ischemic stroke. In this study, we investigated the association of lesion evolution with functional outcome and the influence of successful recanalization on this association. Methods: We included patients from the MR CLEAN trial (Multicenter Random...
Article
Background and purpose: Thrombus perviousness estimates residual flow along a thrombus in acute ischemic stroke, based on radiological images, and may influence the benefit of endovascular treatment for acute ischemic stroke. We aimed to investigate potential endovascular treatment (EVT) effect modification by thrombus perviousness. Methods: We...
Article
Purpose: The first objective of this study was to evaluate the efficacy of a patient-tailored contrast delivery protocol for coronary computed tomography angiography (CTCA), in terms of diagnostic coronary attenuation and total iodine load (TIL), by adjusting the iodine delivery rate (IDR) via dilution for body weight and tube voltage (kV), as com...
Article
Full-text available
Treatment of acute ischemic stroke has been recently improved with the introduction of endovascular mechanical thrombectomy, a minimally invasive procedure able to remove a clot using aspiration devices and/or stent-retrievers. Despite the promising and encouraging results, improvements to the procedure and to the stent design are the focus of the...
Article
Objective To test whether 1) quantitative analysis of EEG reactivity (EEG-R) using machine learning (ML) is superior to visual analysis, and 2) combining quantitative analyses of EEG-R and EEG background pattern increases prognostic value for prediction of poor outcome after cardiac arrest (CA). Methods Several types of ML models were trained with...
Article
Full-text available
Objective Develop and validate models that predict mortality of patients diagnosed with COVID-19 admitted to the hospital. Design Retrospective cohort study. Setting A multicentre cohort across 10 Dutch hospitals including patients from 27 February to 8 June 2020. Participants SARS-CoV-2 positive patients (age ≥18) admitted to the hospital. Mai...
Article
Full-text available
Background: Ischemic lesions commonly continue to progress even days after treatment, and this lesion growth is associated with unfavorable functional outcome in acute ischemic stroke patients. The aim of this study is to elucidate the role of edema in subacute lesion progression and its influence on unfavorable functional outcome by quantifying ne...
Article
Full-text available
Introduction: Radiological thrombus characteristics are associated with patient outcomes and treatment success after acute ischemic stroke. These characteristics could be expected to undergo time-dependent changes due to factors influencing thrombus architecture like blood stasis, clot contraction, and natural thrombolysis. We investigated whether...
Article
Full-text available
Background: Antithrombotic therapy influences clinical outcome after spontaneous intracerebral hemorrhage (ICH). However, evidence on the effect of different antithrombotic therapies on outcome and a comparison between different therapies is scarce, while this is important for medical decision making. Therefore, we investigated clinical outcome aft...
Article
Full-text available
Background We performed an exploratory analysis to identify patient and thrombus characteristics associated with early recanalization in large-vessel occlusion (LVO) stroke patients transferred for endovascular treatment (EVT) from a primary (PSC) to a comprehensive stroke center (CSC). Methods We included patients with an LVO stroke of the anteri...
Article
Full-text available
Importance A carotid web (CW) is a shelf-like lesion along the posterior wall of the internal carotid artery bulb and an underrecognized cause of young stroke. Several studies suggest that patients with symptomatic CW have a high risk of recurrent stroke, but high-quality data are lacking. Objective To assess the 2-year risk of recurrent stroke in...
Article
Full-text available
A reliable and fast instrument for prehospital detection of large vessel occlusion (LVO) stroke would be a game-changer in stroke care, because it would enable direct transportation of LVO stroke patients to the nearest comprehensive stroke center for endovascular treatment. This strategy would substantially improve treatment times and thus clinica...
Article
Importance The benefits of endovascular thrombectomy (EVT) are time dependent. Prior studies may have underestimated the time-benefit association because time of onset is imprecisely known. Objective To assess the lifetime outcomes associated with speed of endovascular thrombectomy in patients with acute ischemic stroke due to large-vessel occlusi...
Article
Full-text available
Purpose Acute stroke patients presenting with a distal internal carotid artery occlusion and patent carotid terminus, allowing for collateral flow via the circle of Willis, may have a more favorable natural history. Therefore, benefit of endovascular treatment (EVT) is less evident. We performed an exploratory analysis of EVT results compared to co...
Article
Objective: Calcified cerebral emboli (CCE) are a rare cause of acute ischemic stroke. The authors aimed to assess the association of CCE with functional outcome, successful reperfusion, and mortality. Furthermore, they aimed to assess the effectiveness of intravenous alteplase treatment and endovascular treatment (EVT), as well as the best first-l...
Article
Full-text available
Acute care demands the collaboration of multiple healthcare professionals and various organisations. During the emergency, the availability of Electronic Medical Records (EMR) allows acute care teams to access a patient's data promptly, which facilitates the decision-making process. Cloud solutions offer an environment to store and share patients'...
Article
Despite the large overall beneficial effects of endovascular treatment in patients with acute ischemic stroke, severe disability or death still occurs in almost one-third of patients. These patients, who might not benefit from treatment, have been previously identified with traditional logistic regression models, which may oversimplify relations be...
Preprint
Development of in silico models of patient-specific cerebral artery networks presents several significant technical challenges: (i) The resolution and smoothness of medical CT images is much lower than the required element/cell length for FEA/CFD/FSI models; (ii) contact between vessels, and indeed self contact of high tortuosity vessel segments ar...
Article
Full-text available
Background Patients with a stroke who are transferred to a comprehensive stroke center for endovascular treatment (EVT) often undergo repeated neuroimaging prior to EVT. Objective To evaluate the yield of repeating imaging and its effect on treatment times. Methods We included adult patients with a large vessel occlusion (LVO) stroke who were ref...
Article
Introduction: Pervious thrombi benefit more from intravenous thrombolysis, but the role of perviousness in endovascular treatment (EVT) is not completely clear. Thrombus length is negatively associated with outcome after EVT. Pervious, long thrombi may be more difficult to aspirate, or fragment more easily than non-pervious, short thrombi. We asses...
Article
Objective: Computed Tomography Perfusion imaging (CTP) allows estimation of tissue status in patients with acute ischemic stroke. We aimed to improve prediction of the final infarct and individual infarct growth rates based on a deep learning approach. Methods: We trained a deep neural network to predict the final infarct volume in patients present...
Article
Introduction: Fast and accurate detection of large vessel occlusions (LVOs) is crucial in selection of patients for endovascular treatment. We assessed the diagnostic performance and speed of an Artifical Intelligence algorithm for automated LVO detection with a novel feature that specifies the exact level of occlusion. Methods: All Computed Tomogr...
Article
A novel model of the leptomeningeal collateral circulation is created by combining data from multiple sources with statistical scaling laws. The extent of the collateral circulation is varied by defining a collateral vessel probability. Blood flow and pressure are simulated using a one-dimensional steady state blood flow model. The leptomeningeal c...
Article
Full-text available
The pathogenic mutation p.Arg14del in the gene encoding Phospholamban (PLN) is known to cause cardiomyopathy and leads to increased risk of sudden cardiac death. Automatic tools might improve the detection of patients with this rare disease. Deep learning is currently the state-of-the-art in signal processing but requires large amounts of data to t...