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P-032 Radiomics based biological assessment of clots to predict first pass effect in mechanical thrombectomy
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P-032 Radiomics based biological assessment of clots to predict first pass effect in mechanical thrombectomy
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Journal Article
P-032 Radiomics based biological assessment of clots to predict first pass effect in mechanical thrombectomy
2025
Overview
BackgroundClots biological composition could affect the first pass effect (FPE) in mechanical thrombectomy (MT). We aimed to biologically profile clots on non-computed tomography (NCCT) through radiomics to assess FPE.MethodsTen clots were retrieved following MT and imaged with micro-Computed tomography (micro-CT) and histologically analyzed. Micro-CT slides were paired with histological cuts. Red blood cells (RBCs), fibrin, white blood cells were identified and matched on micro-CT. 3D Slicer was used to isolate the aforementioned elements and radiomics features (RFs) were retrieved. Multivariate logistic regression was conducted to identify RFs associated to these components. Spearman’s rank correlation was used to correlate Micro-CT RFs with percentage of biological composition. The ten clots were identified in NCCT and NCCT RFs were retrieved. Similarly, micro-CT and NCCT RFs were then correlated. Receiver operating characteristic (ROC) sensitivity (SN) and specificity (SP) analysis was conducted to retrieve optimal thresholds for RFs associated to biological components in NCCT. Moreover, a large set of NCCT images of clots retrieved after MT were biologically evaluated through radiomics. Finally, a logistic regression was conducted to find an association between clots biological composition and rates of FPE. FPE was defined as modified treatment in cerebral infarction (mTICI) more or equal than 2c on first MT attempt.ResultsTotal Energy (TE) (OR: 1.35, 95% CI: 1.20–1.54, P= <.001) and Large Dependence High Gray Level Emphasis (LDHGLE) (OR: 1.18, 95% CI: 1.07–1.32, P= 0.01) were associated with RBCs in micro-CT. Additionally, TE and LDHGLE were correlated with histological slides with > 70% of RBCs (Rho 0.654 and Rho 0.721, respectively) and NCCT TE and LDHGLE (Rho 0.687 and Rho 0.657, respectively) of clots that had > 70% of RBCs per histology. No association was found between RFs and remaining clots components. ROC analysis showed that TE and LDHGLE were sensitive (67% and 67%, respectively) and specific (71% and 86%, respectively) to identify RBCs clot composition higher than 70% in NCCT. TE and LDHGLE thresholds were applied in 150 NCCT images of clots showing that 76/150 (51%) of clots had RBCs as main component. FPE was achieved in 54/150 (36%) of these cases. The presence of more than 70% of RBCs among clots were associated with higher odds of achieving FPE (OR: 2.1, 95% CI: 1.5–4.1, P= 0.001)ConclusionRadiomics hold promise to analyze rates of FPE considering clots RBCs biological composition.Abstract P-032 Figure 1DisclosuresA. Gudino: None. C. Dier: None. N. Shenoy: None. D. Cifuentes: None. R. Calle: None. P. Martinez: None. E. Sagues: None. C. Aamot: None. E. Samaniego: None.
Publisher
BMJ Publishing Group LTD
Subject
