Based on hematoma and perihematomal tissue NCCT imaging radiomics predicts early clinical outcome of conservatively treated spontaneous cerebral hemorrhage.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE

Original Publication: London : Nature Publishing Group, copyright 2011-

Cerebral Hemorrhage*/diagnostic imaging ; Cerebral Hemorrhage*/therapy ; Hematoma*/diagnostic imaging ; Hematoma*/therapy ; Tomography, X-Ray Computed*/methods; Humans ; Male ; Female ; Aged ; Middle Aged ; Retrospective Studies ; Prognosis ; Conservative Treatment/methods ; Treatment Outcome ; ROC Curve ; Radiomics

Spontaneous intracerebral hemorrhage (ICH) is a very serious kind of stroke. If the outcome of patients can be accurately assessed at the early stage of disease occurrence, it will be of great significance to the patients and clinical treatment. The present study was conducted to investigate whether non-contrast computer tomography (NCCT) models of hematoma and perihematomal tissues could improve the accuracy of short-term prognosis prediction in ICH patients with conservative treatment. In this retrospective analysis, a total of 166 ICH patients with conservative treatment during hospitalization were included. Patients were randomized into a training group (N = 132) and a validation group (N = 34) in a ratio of 8:2, and the functional outcome at 90 days after clinical treatment was assessed by the modified Rankin Scale (mRS). Radiomic features of hematoma and perihematomal tissues of 5 mm, 10 mm, 15 mm were extracted from NCCT images. Clinical factors were analyzed by univariate and multivariate logistic regression to identify independent predictive factors. In the validation group, the mean area under the ROC curve (AUC) of the hematoma was 0.830, the AUC of the perihematomal tissue within 5 mm, 10 mm, 15 mm was 0.792, 0.826, 0.774, respectively, and the AUC of the combined model of hematoma and perihematomal tissue within 10 mm was 0.795. The clinical-radiomics nomogram consisting of five independent predictors and radiomics score (Rad-score) of the hematoma model were used to assess 90-day functional outcome in ICH patients with conservative treatment. Our findings found that the hematoma model had better discriminative efficacy in evaluating the early prognosis of conservatively managed ICH patients. The visual clinical-radiomics nomogram provided a more intuitive individualized risk assessment for 90-day functional outcome in ICH patients with conservative treatment. The hematoma could remain the primary therapeutic target for conservatively managed ICH patients, emphasizing the need for future clinical focus on the biological significance of the hematoma itself.
(© 2024. The Author(s).)

Lancet. 2013 Aug 3;382(9890):397-408. (PMID: 23726393)
Int J Stroke. 2015 Jun;10(4):576-81. (PMID: 25580771)
Radiology. 2016 Feb;278(2):563-77. (PMID: 26579733)
J Cereb Blood Flow Metab. 2011 Jun;31(6):1387-93. (PMID: 21266984)
J Clin Oncol. 2016 Jun 20;34(18):2157-64. (PMID: 27138577)
Cerebrovasc Dis. 2016;42(3-4):155-69. (PMID: 27110940)
Stroke. 2009 Apr;40(4):1533-8. (PMID: 19246695)
Lancet Neurol. 2019 Sep;18(9):857-864. (PMID: 31397290)
J Korean Neurosurg Soc. 2009 Jun;45(6):341-9. (PMID: 19609417)
Neurology. 2016 Jul 19;87(3):257-62. (PMID: 27281527)
Stroke. 2016 May;47(5):1227-32. (PMID: 27073236)
Magn Reson Imaging. 2012 Nov;30(9):1323-41. (PMID: 22770690)
EBioMedicine. 2019 May;43:454-459. (PMID: 31060901)
Neurobiol Dis. 2023 Jan;176:105948. (PMID: 36481437)
Stroke Vasc Neurol. 2023 Apr;8(2):111-118. (PMID: 36137597)
Stroke. 2020 Mar;51(3):830-837. (PMID: 31906832)
Front Immunol. 2021 Oct 19;12:740632. (PMID: 34737745)
Eur Radiol. 2021 Jul;31(7):4949-4959. (PMID: 33733691)
Lancet. 2018 Oct 6;392(10154):1257-1268. (PMID: 30319113)
Lancet. 2005 Jan 29-Feb 4;365(9457):387-97. (PMID: 15680453)
Neurol Sci. 2016 Oct;37(10):1693-700. (PMID: 27393282)
Stroke. 2011 Jan;42(1):73-80. (PMID: 21164136)
J Stroke Cerebrovasc Dis. 2022 Jun;31(6):106475. (PMID: 35417846)
Neurocrit Care. 2020 Oct;33(2):525-532. (PMID: 32043266)
Neurocrit Care. 2022 Aug;37(1):111-120. (PMID: 35386067)
Eur J Cancer. 2012 Mar;48(4):441-6. (PMID: 22257792)
J Physiother. 2022 Oct;68(4):281. (PMID: 35715375)
Stroke. 1988 Jul;19(7):852-6. (PMID: 2455366)
Cerebrovasc Dis. 2001;11(3):183-9. (PMID: 11306765)
Stroke. 2009 Apr;40(4):1325-31. (PMID: 19286590)

Date Created: 20240809 Date Completed: 20240809 Latest Revision: 20240814

20240814

PMC11315882

10.1038/s41598-024-69249-y

39122887