Abstract 133: Radiomic profile of aneurysm is correlated with clinical scales, morphology, and wall enhancement

• Published in: Stroke: vascular and interventional neurology 2024-11, Vol.4 (S1)
• Main Authors: Dier, C, Gudino, A, Sagues, E, Sanchez, S, Cabarique, M, Shenoy, N, Torres, M, Aamot, C, Samaniego, E A
• Format: Article
• Language: English
• Subjects: Aneurysms; Magnetic resonance imaging; Morphology; Radiomics
• ISSN: 2694-5746; 2694-5746
• DOI: 10.1161/SVIN.04.suppl_1.133

IntroductionClinical scales and intracranial aneurysm (IA) morphology are predictors of rupture risk. High‐resolution magnetic resonance imaging (HR‐MRI), aneurysm wall enhancement (AWE) quantification, and radiomics, which can extract detailed data on the voxels signal intensity (SI) within the vessel wall, can enhance risk assessment. We aimed to analyze the differences in radiomic profiles (RPs) between high‐risk and low‐risk IAs and to explore their relationship with clinical scales, morphological metrics, and AWE.MethodsPatients with unruptured saccular IAs underwent HR‐MRI. Clinical information was retrieved, and morphological measurements, including size, size ratio (SR), and aspect ratio (AR), were obtained from angiographic studies. Clinical scale scores (PHASES and ELAPSS) were then calculated. A 3D method was used to quantify the mean SI of the aneurysm surface (3D‐CAWE = SI of the aneurysms body/corpus callosum ratio), and an IA was classified as objectively enhancing if the 3D‐CAWE value was higher than 1. 3D Slicer was utilized to generate three‐dimensional segmentations of the IAs. Radiomic features (RFs) were extracted from the T1Gd images using an add‐in. IAs were categorized as high‐risk based on the following criteria: ELAPSS ≥17, PHASES ≥5, size ≥7 mm, SR ≥2.3, AR ≥1.5, and 3D‐CAWE+ ≥1. The Mann‐Whitney test was used to compare the RPs between high‐risk and low‐risk IAs. Spearman's correlation was utilized to assess the relationships between RP and clinical scale scores, morphology, and 3D‐CAWE values.ResultsNinety‐two patients with 113 saccular IAs were evaluated. Forty‐seven percent (53/113) and 50% (57/113) of the IAs were classified as high‐risk by ELAPSS and PHASES scores, respectively. Thirty‐eight percent (43/113) of the IAs had a size ≥7 mm, 43% (49/113) had a SR ≥2.3, and 37% (42/113) had an AR ≥1.5. Seventeen percent (19/113) of the IAs were classified as 3D‐CAWE+. Of the RFs that differed between high‐risk and low‐risk IAs, 55 RFs were identified based on ELAPSS (51%), 40 RFs by PHASES (37%), 74 RFs by size (69%), 69 RFs by SR (64%), 21 RFs by AR (20%), and 60 RFs based on 3D‐CAWE+ (56%). Among the RFs that differed based on risk stratification, 36% (20/55) were strongly correlated with ELAPSS, 30% (22/74) with size, 14% (10/69) with SR, and 27% (16/60) with 3D‐CAWE. No correlations between RFs and PHASES or AR were observed.ConclusionHigh‐risk IAs exhibit different RPs compared to those of lower‐risk IAs. These RPs show stro