Clinical study on forecasting the prognosis of patients with cerebellar hemorrhage based on CT radiomics models

Abstract

Background and purposeWe created and verified a clinical–radiomics nomogram to forecast the prognosis of patients with cerebellar hemorrhage. Materials and MethodsEighty-eight patients with cerebellar hemorrhage from two different hospitals were retrospectively analyzed (62 cases from first hospital (training cohort) and 27 cases from second hospital (external validation cohort)). All patients underwent computed tomography scanning within 72 hours of the onset of cerebellar hemorrhage and were split into two categories based on their prognosis. Clinically independent risk factors were identified using the independent samples t-test and binary logistic regression analysis. Radiomic features were obtained using the SelectkBest, variance threshold, least absolute shrinkage, and selection operator. Radiomics scores (rad-scores) were produced from eight radiomics features of perihematomal edema (PHE) and hematoma associated with cerebellar hemorrhage prognosis. Logistic regression analyses of the rad-scores against clinical risk factors yielded clinical–radiomics column line plots. Predictive performance of the column line plots was validated using decision curve analysis analyses in both the training and external validation cohorts. ResultsTo construct rad-scores, eight radiomics traits and four clinical risk factors were combined to create clinical–radiomics models. In both the training cohort (area under the curve [AUC], 0.96 versus vs. 0.87/0.84) and the external validation cohort (AUC: 0.93 vs. 0.74/0.69), the clinical–radiomics nomogram achieved superior performance to the clinical and radiomics nomogram models. Clinical–radiomics column line plot demonstrated satisfactory calibration and clinical advantages in both cohorts. ConclusionsRadiomics features of PHE and hematoma can predict cerebellar hemorrhage prognosis. Clinical–radiomics models can help clinicians make individualized clinical treatment decisions and efficacy assessments for patients with cerebellar hemorrhage, help physicians prepare for possible deterioration, and promptly communicate treatment goals and efficacy expectations to patients and their families.