RT Journal Article
SR Electronic
T1 Thrombus radiomics in patients with anterior circulation acute ischemic stroke undergoing endovascular treatment
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP e79
OP e85
DO 10.1136/jnis-2022-019085
VO 15
IS e1
A1 van Voorst, Henk
A1 Bruggeman, Agnetha A E
A1 Yang, Wenjin
A1 Andriessen, Jurr
A1 Welberg, Elise
A1 Dutra, Bruna G
A1 Konduri, Praneeta R
A1 Arrarte Terreros, Nerea
A1 Hoving, Jan W
A1 Tolhuisen, Manon L
A1 Kappelhof, Manon
A1 Brouwer, Josje
A1 Boodt, Nikki
A1 van Kranendonk, Katinka R
A1 Koopman, Miou S
A1 Hund, Hajo M
A1 Krietemeijer, Menno
A1 van Zwam, Wim H
A1 van Beusekom, Heleen M M
A1 van der Lugt, Aad
A1 Emmer, Bart J
A1 Marquering, Henk A
A1 Roos, Yvo B W E M
A1 Caan, Matthan W A
A1 Majoie, Charles B L M
A1 
YR 2023
UL http://jnis.bmj.com/content/15/e1/e79.abstract
AB 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 699 patients included in the MR CLEAN Registry. In a pilot study, we selected 51 TR with consistent values across two raters’ segmentations (ICC >0.75). Random forest models using TR in addition or as a substitute to baseline clinical variables (CV) and manual thrombus measurements (MTM) were trained with 499 patients and evaluated on 200 patients for predicting successful reperfusion (extended Thrombolysis in Cerebral Ischemia (eTICI) ≥2B), first attempt reperfusion, reperfusion within three attempts, and functional independence (modified Rankin Scale (mRS) ≤2). Three texture and shape features were selected based on feature importance and related to eTICI ≥2B, number of attempts to eTICI ≥2B, and 90-day mRS with ordinal logistic regression.Results Random forest models using TR, CV or MTM had comparable predictive performance. Thrombus texture (inverse difference moment normalized) was independently associated with reperfusion (adjusted common OR (acOR) 0.85, 95% CI 0.72 to 0.99). Thrombus volume and texture were also independently associated with the number of attempts to successful reperfusion (acOR 1.36, 95% CI 1.03 to 1.88 and acOR 1.24, 95% CI 1.04 to 1.49).Conclusions TR describing thrombus volume and texture were associated with more attempts to successful reperfusion. Compared with models using CV and MTM, TR had no added value for predicting procedural and functional outcome.Data are available upon reasonable request. Data requests forms can be obtained at the MR CLEAN website: www.mrclean-trial.org. All code is made available on github: github.com/henkvanvoorst92/Radiomics.