Purpose

Our aim was to evaluate the performance of clot-based radiomics features (RFs) for predicting first pass effect (FPE) in patients with acute ischemic stroke (AIS). The secondary purpose was to search for any other variables associated with FPE.

Materials and methods

Patients who underwent mechanical thrombectomy (MT) for anterior circulation large vessel stroke in a single center were retrospectively reviewed. Patients were divided into two groups: FPE and non-FPE. Two observers extracted RFs from the clot on pretreatment noncontrast computed tomography (NCCT) images. Demographic, clinical, periprocedural, and RFs were compared between the groups and receiver operating characteristic (ROC) curves were constructed. Logistic regression analysis was used to determine the independent predictors of FPE.

Results

Fifty-two patients (27 female, 25 male; mean age 64.50 ± 15.15) who were treated by stent retrievers as the first option were included in the study. FPE was achieved in 25 patients (25/52, 48.1%). Twelve RFs were significantly different between patients with FPE and non-FPE. The long-run low gray-level emphasis (odds ratio = 44.24, p = 0.003) and the zone percentage (odds ratio = 16.88, p = 0.017) were found as independent predictors of FPE. Female sex and a baseline ASPECT score of >8.5 were the other independent variables to predict FPE. The diagnostic accuracy to predict FPE was observed as 83% when using all independent predictors in our predictive model.

Conclusions

Clot-based RFs on NCCT may help to estimate the success of the intended outcome of MT in patients with AIS.

中文翻译：

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基于凝块的放射组学特征预测急性缺血性卒中的首过效应

目的

我们的目的是评估基于凝块的放射组学特征 (RF) 在预测急性缺血性卒中 (AIS) 患者的首过效应 (FPE) 方面的性能。次要目的是搜索与 FPE 相关的任何其他变量。

材料和方法

回顾性分析了在单中心接受机械血栓切除术 (MT) 治疗前循环大血管卒中的患者。患者分为两组：FPE 和非 FPE。两名观察员从预处理非对比计算机断层扫描 (NCCT) 图像上的凝块中提取了 RF。比较各组之间的人口统计学、临床、围手术期和 RFs，并构建接受者操作特征 (ROC) 曲线。逻辑回归分析用于确定 FPE 的独立预测因子。

结果

本研究纳入了 52 名患者（27 名女性，25 名男性；平均年龄 64.50 ± 15.15 岁），他们将支架回收器作为第一选择进行治疗。25 名患者 (25/52, 48.1%) 实现了 FPE。FPE 和非 FPE 患者的 12 个 RF 显着不同。长期低灰度强调（比值比 = 44.24，p = 0.003）和区域百分比（比值比 = 16.88，p = 0.017）被发现是 FPE 的独立预测因子。女性性别和 >8.5 的基线 ASPECT 评分是预测 FPE 的其他自变量。在我们的预测模型中使用所有独立预测因子时，预测 FPE 的诊断准确度为 83%。

结论

NCCT 上基于凝块的 RF 可能有助于评估 AIS 患者 MT 预期结果的成功率。