A clinical-radiomics based nomogram to predict progressive intraparenchymal hemorrhage in mild to moderate traumatic injury patients

Abstract

PurposeTo develop a non-contrast computed tomography(NCCT)based radiomics model for predicting intraparenchymal hemorrhage progression in patients with mild to moderate traumatic brain injury(TBI). MethodsWe retrospectively analyzed 166 mild to moderate TBI patients with intraparenchymal hemorrhage from January 2018 to December 2021. The enrolled patients were divided into training cohort and test cohort with a ratio of 6:4. Uni- and multivariable logistic regression analyses were implemented to screen clinical-radiological factors and to establish a clinical-radiological model. Model performance was evaluated by the area under the receiver operating characteristic curve (AUC), the calibration curve, the decision curve analysis, sensitivity, and specificity. ResultsEleven radiomics features, presence with SDH, and D-dimer > 5 mg/l were selected to construct the combined clinical-radiomic model for the prediction of TICH in mild to moderate TBI patients. The AUC of the combined model was 0.81(95% confidence interval (CI), 0.72 to 0.90) in the training cohort and 0.88 (95% CI 0.79 to 0.96) in the test cohort, which were superior to the clinical model alone (AUCtraining = 0.72, AUCtest = 0.74). The calibration curve demonstrated that the radiomics nomogram had a good agreement between prediction and observation. Decision curve analysis confirmed clinically useful. ConclusionsThe combined clinical-radiomic model that incorporates the radiomics score and clinical risk factors can serve as a reliable and powerful tool for Predicting intraparenchymal hemorrhage progression for patients with mild to moderate TBI.