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Combined Radiomics Model for Prediction of Hematoma Progression and Clinical Outcome of Cerebral Contusions in Traumatic Brain Injury

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Abstract

Background

Traumatic brain injury is a common and devastating injury that is the leading cause of neurological disability and death worldwide. Patients with cerebral lobe contusion received conservative treatment because of their mild manifestations, but delayed intracranial hematoma may increase and even become life-threatening. We explored the noninvasive method to predict the prognosis of progression and Glasgow Outcome Scale (GOS) by using a quantitative radiomics approach and statistical analysis.

Methods

Eighty-eight patients who were pathologically diagnosed were retrospectively studied. The radiomics method developed in this work included image segmentation, feature extraction, and feature selection. The nomograms were established based on statistical analysis and a radiomics method. We conducted a comparative study of hematoma progression and GOS between the clinical factor alone and fusion radiomics features.

Results

Nineteen clinical factors, 513 radiomics features, and 116 locational features were considered. Among clinical factors, international normalized ratio, prothrombin time, and fibrinogen were enrolled for hematoma progression. As for GOS, treatment strategy, age, Glasgow Coma Scale score, and blood platelet were associated factors. Eight features for GOS and five features for hematoma progression were filtered by using sparse representation and locality preserving projection-combined method. Four nomograms were constructed. After fusion radiomics features, area under the curve of hematoma progression prediction increased from 0.832 to 0.899, whereas GOS prediction went from 0.794 to 0.844.

Conclusions

A radiomic-based model that merges radiomics and clinical features is a noninvasive approach to predict hematoma progression and clinical outcomes of cerebral contusions in traumatic brain injury.

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Funding

This study was supported by the Shanghai Municipal Science and Technology Major Project (No. 2018SHZDZX01) and ZJLab, National Natural Science Foundation of China (91959127), The Natural Science Foundation and Major Basic Research Program of Shanghai (16JC1420100), and Shanghai Muncipal Health Commission Project (2018ZHYL0107).

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Authors and Affiliations

  1. Department of Electronic Engineering, Fudan University, Shanghai, China

    Liqiong Zhang, Guoqing Wu & Jinhua Yu

  2. Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China

    Qiyuan Zhuang, Zhifeng Shi, Qiang Yuan, Jian Yu & Jin Hu

  3. Shanghai Brain Function Restoration and Neural Regenerative Key Laboratory, Shanghai, China

    Qiyuan Zhuang, Zhifeng Shi, Qiang Yuan, Jian Yu & Jin Hu

Author notes

  1. Liqiong Zhang and Qiyuan Zhuang are contributed equally to this paper.

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    1. Liqiong Zhang
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    Contributions

    L.Z. and Q.Z. contributed equally to this work. J.Y. and Q.Y: Study concept and design. L.Z. and Q.Z: Drafting of the manuscript. Q.Z: Statistical analysis. L.Z. and Q.Z: Interpretation of data. J.H., J.Y. and Q.Y: Critical revision of the manuscript for important intellectual content. G.W., J.Y., and Z.S: Administrative, technical, or material support.

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    Correspondence to Qiang Yuan or Jian Yu.

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    Zhang, L., Zhuang, Q., Wu, G. et al. Combined Radiomics Model for Prediction of Hematoma Progression and Clinical Outcome of Cerebral Contusions in Traumatic Brain Injury. Neurocrit Care 36, 441–451 (2022). https://doi.org/10.1007/s12028-021-01320-2

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