DOI: 10.1161/str.55.suppl_1.tmp80 ISSN: 0039-2499

Abstract TMP80: Hematoma Radiomic Markers of Survival After Supratentorial Intracerebral Hemorrhage on Admission Non-Contrast Head CT

Saif Zaman, Fiona Dierksen, Stefan Haider, Adnan I Qureshi, David J Werring, Ajay Malhotra, Guido J Falcone, Kevin N Sheth, Seyedmehdi Payabvash
  • Advanced and Specialized Nursing
  • Cardiology and Cardiovascular Medicine
  • Neurology (clinical)

Background: Radiomic features provide quantitative information about lesions morphology and texture on medical images. Recent studies have shown that intracerebral hemorrhage (ICH) radiomics on admission non-contrast head CT are associated with severity of symptoms at baseline and clinical outcomes - providing prognostic information beyond hematoma volume. In this study, we determined hematoma radiomic markers of post-ICH survival on admission head CT.

Methods: Using the ATACH-2 trial dataset, we manually segmented ICH on admission head CTs and extracted 1130 radiomic features. Univariate and multivariate survival analyses were performed using the Cox Proportional Hazards model, Kaplan Meier Analysis, and logistic regression.

Results: We split our dataset (n=871) to training (n=580) and testing (n=291) cohorts. Increased “original first order Energy” radiomic feature was associated with a higher probability of death (Hazard Ratio=1.64, p <0.0001). LASSO Cox Proportional Hazards modeling also identified “original first order Energy” alongside age, NIHSS, and baseline INR as significant predictors of death. The ROC analysis confirmed the prognostic capability of this feature at 7 days, 30 days, and 90 days post-ICH in training and test cohorts. Kaplan Meier analysis demonstrated that increased “original first order Energy” is associated with a higher probability of death (p < 0.05 at all time points). Logistic regression also showed that this feature is an independent predictor of post-ICH mortality (Odds ratios=2.04, p < 0.001).

Conclusions: The “original first order Energy” radiomic feature of hematoma on admission non-contrast head CT scans is a main predictor of survival in supratentorial ICH. This radiomic feature represents the magnitude of voxel values confounded with lesion volume - i.e. brighter larger hematomas on head CT have higher " original first order Energy ", and are associated with higher mortality rates after supratentorial ICH.

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