Abstract

BackgroundTo assess the potential of radiomic features to quantify components of blood in intraaortic vessels to non-invasively predict moderate-to-severe anemia in non-contrast enhanced CT scans.MethodsOne hundred patients (median age, 69 years; range, 19–94 years) who received CT scans of the thoracolumbar spine and blood-testing for hemoglobin and hematocrit levels ± 24 h between 08/2018 and 11/2019 were retrospectively included. Intraaortic blood was segmented using a spherical volume of interest of 1 cm diameter with consecutive radiomic analysis applying PyRadiomics software. Feature selection was performed applying analysis of correlation and collinearity. The final feature set was obtained to differentiate moderate-to-severe anemia. Random forest machine learning was applied and predictive performance was assessed. A decision-tree was obtained to propose a cut-off value of CT Hounsfield units (HU).ResultsHigh correlation with hemoglobin and hematocrit levels was shown for first-order radiomic features (p < 0.001 to p = 0.032). The top 3 features showed high correlation to hemoglobin values (p) and minimal collinearity (r) to the top ranked feature Median (p < 0.001), Energy (p = 0.002, r = 0.387), Minimum (p = 0.032, r = 0.437). Median (p < 0.001) and Minimum (p = 0.003) differed in moderate-to-severe anemia compared to non-anemic state. Median yielded superiority to the combination of Median and Minimum (p(AUC) = 0.015, p(precision) = 0.017, p(accuracy) = 0.612) in the predictive performance employing random forest analysis. A Median HU value ≤ 36.5 indicated moderate-to-severe anemia (accuracy = 0.90, precision = 0.80).ConclusionsFirst-order radiomic features correlate with hemoglobin levels and may be feasible for the prediction of moderate-to-severe anemia. High dimensional radiomic features did not aid augmenting the data in our exemplary use case of intraluminal blood component assessment.Trial registration Retrospectively registered.

Highlights

  • To assess the potential of radiomic features to quantify components of blood in intraaortic vessels to non-invasively predict moderate-to-severe anemia in non-contrast enhanced Computed tomography (CT) scans

  • In this study, we examined the potential of high dimensional radiomic features to assess components of the moving blood compartment

  • We obtained simple histogram and high dimensional radiomic features and could demonstrate that histogram radiomic features enable an accurate differentiation of moderate-to-severe anaemic state and non-anemic state employing non-enhanced CT scans

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Summary

Introduction

To assess the potential of radiomic features to quantify components of blood in intraaortic vessels to non-invasively predict moderate-to-severe anemia in non-contrast enhanced CT scans. Radiomics is a term coined for computational quantitative imaging analysis and has been shown to aid in clinical decision making [1]. In emergency patients with acute blood loss, fast assessment of a multitude of blood components, for example hemoglobin and hematocrit levels is essential [10, 11]. Noninvasive screening of blood components in a clinically indicated CT may yield the potential to assess specific blood components in order to focus invasive testing on pre-filtered components and patients to reduce workload and costs of laboratory analyses [16]

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