Radiomics for Predicting the Development of Brain Edema from Normal-Appearing Early Brain-CT After Cardiac Arrest and Return of Spontaneous Circulation
<b>Background:</b> Hypoxic-ischemic brain injury (HIBI) is a feared complication post-cardiac arrest (CA). The timing of brain imaging remains a topic of ongoing debate. Early computed tomography (CT) scans can reveal acute intracranial pathologies but may have limited predictive value d...
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2025-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/15/2/119 |
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| author | Michael Scheschenja Eva-Marie Müller-Stüler Simon Viniol Joel Wessendorf Moritz B. Bastian Jarmila Jedelská Alexander M. König Andreas H. Mahnken |
| author_facet | Michael Scheschenja Eva-Marie Müller-Stüler Simon Viniol Joel Wessendorf Moritz B. Bastian Jarmila Jedelská Alexander M. König Andreas H. Mahnken |
| author_sort | Michael Scheschenja |
| collection | DOAJ |
| description | <b>Background:</b> Hypoxic-ischemic brain injury (HIBI) is a feared complication post-cardiac arrest (CA). The timing of brain imaging remains a topic of ongoing debate. Early computed tomography (CT) scans can reveal acute intracranial pathologies but may have limited predictive value due to delayed manifestation of HIBI-related changes. Radiomics analyses present a promising approach to identifying subtle imaging markers, potentially aiding early HIBI detection. <b>Methods:</b> This study retrospectively assessed post-CA patients between 2016 and 2023 who received immediate brain CTs. Patients without acute intracranial pathology on initial scans and who underwent follow-up brain CTs within 14 days post-return of spontaneous circulation (ROSC) were included. Image segmentation involved manual basalganglia segmentation and automated whole-brain segmentation. Radiomics features were calculated using Pyradiomics (v3.0.1) in 3DSlicer (v5.2.2). Feature selection involved reproducibility analysis via ICC and LASSO regression, retaining five features per segmentation method. A logistic regression model for each segmentation method underwent 5-fold cross-validation. Results were summarized with ROC analyses and average sensitivity and specificity. <b>Results:</b> A total of 83 patients (average age: 65 ± 13.3 years, 19 women) with CA and ROSC were included. Follow-up CT scans after 5.2 ± 2.9 days revealed brain edema in 47 patients. The model using manual segmentation achieved an average AUC of 0.76, sensitivity of 0.59, and specificity of 0.78. The automated segmentation model showed an average AUC of 0.66, sensitivity of 0.49, and specificity of 0.68. <b>Conclusions:</b> Radiomics, particularly focused on the basalganglia area in normal-appearing brain CTs after CA and ROSC, may enhance predictive insights for HIBI and the development of brain edema. |
| format | Article |
| id | doaj-art-786573c358c54e34bcd3ff9e7be13436 |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-786573c358c54e34bcd3ff9e7be134362025-01-24T13:28:47ZengMDPI AGDiagnostics2075-44182025-01-0115211910.3390/diagnostics15020119Radiomics for Predicting the Development of Brain Edema from Normal-Appearing Early Brain-CT After Cardiac Arrest and Return of Spontaneous CirculationMichael Scheschenja0Eva-Marie Müller-Stüler1Simon Viniol2Joel Wessendorf3Moritz B. Bastian4Jarmila Jedelská5Alexander M. König6Andreas H. Mahnken7Clinic of Diagnostic and Interventional Radiology, Marburg University Hospital, Philipps-University Marburg, Baldingerstrasse, 35043 Marburg, GermanyClinic of Diagnostic and Interventional Radiology, Marburg University Hospital, Philipps-University Marburg, Baldingerstrasse, 35043 Marburg, GermanyClinic of Diagnostic and Interventional Radiology, Marburg University Hospital, Philipps-University Marburg, Baldingerstrasse, 35043 Marburg, GermanyClinic of Diagnostic and Interventional Radiology, Marburg University Hospital, Philipps-University Marburg, Baldingerstrasse, 35043 Marburg, GermanyClinic of Diagnostic and Interventional Radiology, Marburg University Hospital, Philipps-University Marburg, Baldingerstrasse, 35043 Marburg, GermanyClinic of Diagnostic and Interventional Radiology, Marburg University Hospital, Philipps-University Marburg, Baldingerstrasse, 35043 Marburg, GermanyClinic of Diagnostic and Interventional Radiology, Marburg University Hospital, Philipps-University Marburg, Baldingerstrasse, 35043 Marburg, GermanyClinic of Diagnostic and Interventional Radiology, Marburg University Hospital, Philipps-University Marburg, Baldingerstrasse, 35043 Marburg, Germany<b>Background:</b> Hypoxic-ischemic brain injury (HIBI) is a feared complication post-cardiac arrest (CA). The timing of brain imaging remains a topic of ongoing debate. Early computed tomography (CT) scans can reveal acute intracranial pathologies but may have limited predictive value due to delayed manifestation of HIBI-related changes. Radiomics analyses present a promising approach to identifying subtle imaging markers, potentially aiding early HIBI detection. <b>Methods:</b> This study retrospectively assessed post-CA patients between 2016 and 2023 who received immediate brain CTs. Patients without acute intracranial pathology on initial scans and who underwent follow-up brain CTs within 14 days post-return of spontaneous circulation (ROSC) were included. Image segmentation involved manual basalganglia segmentation and automated whole-brain segmentation. Radiomics features were calculated using Pyradiomics (v3.0.1) in 3DSlicer (v5.2.2). Feature selection involved reproducibility analysis via ICC and LASSO regression, retaining five features per segmentation method. A logistic regression model for each segmentation method underwent 5-fold cross-validation. Results were summarized with ROC analyses and average sensitivity and specificity. <b>Results:</b> A total of 83 patients (average age: 65 ± 13.3 years, 19 women) with CA and ROSC were included. Follow-up CT scans after 5.2 ± 2.9 days revealed brain edema in 47 patients. The model using manual segmentation achieved an average AUC of 0.76, sensitivity of 0.59, and specificity of 0.78. The automated segmentation model showed an average AUC of 0.66, sensitivity of 0.49, and specificity of 0.68. <b>Conclusions:</b> Radiomics, particularly focused on the basalganglia area in normal-appearing brain CTs after CA and ROSC, may enhance predictive insights for HIBI and the development of brain edema.https://www.mdpi.com/2075-4418/15/2/119cardiac arrestreturn of spontaneous circulationhypoxic-ischemic brain injuryradiomicsmachine learning |
| spellingShingle | Michael Scheschenja Eva-Marie Müller-Stüler Simon Viniol Joel Wessendorf Moritz B. Bastian Jarmila Jedelská Alexander M. König Andreas H. Mahnken Radiomics for Predicting the Development of Brain Edema from Normal-Appearing Early Brain-CT After Cardiac Arrest and Return of Spontaneous Circulation Diagnostics cardiac arrest return of spontaneous circulation hypoxic-ischemic brain injury radiomics machine learning |
| title | Radiomics for Predicting the Development of Brain Edema from Normal-Appearing Early Brain-CT After Cardiac Arrest and Return of Spontaneous Circulation |
| title_full | Radiomics for Predicting the Development of Brain Edema from Normal-Appearing Early Brain-CT After Cardiac Arrest and Return of Spontaneous Circulation |
| title_fullStr | Radiomics for Predicting the Development of Brain Edema from Normal-Appearing Early Brain-CT After Cardiac Arrest and Return of Spontaneous Circulation |
| title_full_unstemmed | Radiomics for Predicting the Development of Brain Edema from Normal-Appearing Early Brain-CT After Cardiac Arrest and Return of Spontaneous Circulation |
| title_short | Radiomics for Predicting the Development of Brain Edema from Normal-Appearing Early Brain-CT After Cardiac Arrest and Return of Spontaneous Circulation |
| title_sort | radiomics for predicting the development of brain edema from normal appearing early brain ct after cardiac arrest and return of spontaneous circulation |
| topic | cardiac arrest return of spontaneous circulation hypoxic-ischemic brain injury radiomics machine learning |
| url | https://www.mdpi.com/2075-4418/15/2/119 |
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