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Abstract Details

Characterization of Clot Composition Through Radiomic Features
Cerebrovascular Disease and Interventional Neurology
P1 - Poster Session 1 (11:45 AM-12:45 PM)
13-018
Characterize clots biological composition in non-contrast computed tomography (NCCT) images.
Clots composition could provide insights of the etiology in acute ischemic stroke (AIS). Radiomics is a non-invasive imaging tool that can characterize images at a voxel-by-voxel level. We correlated the histology of clots from patients with large vessel occlusion (LVO) with specific radiomic features (RFs)to characterize clot composition. 

Ten clots retrieved from mechanical thrombectomy were imaged using micro-computed tomography (micro-CT) and histologically analyzed. RFs from each clot were extracted with 3D-Slicer and were correlated with different clot components determined by histology.  NCCT and computed tomography angiography images were co-registered with the corresponding slices obtained from histology.  A large cohort of 426 patient with NCCT obtained at the time of presentation were then analyzed.  
In micro-CT, total energy (TE), joint average (JA) and large dependence high gray level emphasis (LDHGLE) were associated to RBCs (p<0.001, p 0.003, and p<0.002, respectively). Fibrin's RFs included minimum (p .005). TE, JA and LDHGLE were correlated with clots composed by 70% RBCs (Rho 0.654 and 0.652, respectively). Minimum was strongly correlated (Rho 0.795) with clots with >80% of fibrin. TE (Rho 0.687) JA (0.809) and LDHGLE (rho 0.657) were correlated between micro-CT and NCCT. Minimum values were negatively correlated (Rho -0.851). TE (sensitivity 0.750, specificity 0.800) and LDHGLE (sensitivity 0.750, specificity 0.800) were accurate to determine RBCs composition in NCCT. Mnimum (sensitivity: 0.500, specificity: 0.400) was not accurate for fibrin determination. 145 of 426 patients NCCT images were finally analyzed. 50 patients have a stroke of cardioembolic origin, 45 due to large artery atherosclerosis (LAA) and 50 were cryptogenic. Radiomics analysis showed that, 35 (75%) cardioembolic, 12 (27%) of LAA and 25 (50%) of cryptogenic AIS were mainly composed of RBCs.

RFs are sensitive and specific to determine clots rich in RBCs composition in NCCT.

Authors/Disclosures
Andres Gudino (University of Iowa Hospitals and Clinics)
PRESENTER 		Mr. Gudino has nothing to disclose.
Carlos Dier No disclosure on file
Martin A. Cabarique, MD Dr. Cabarique has nothing to disclose.
Elena Sagues, MD (University of Iowa Hospitals and Clinics) Ms. Sagues has nothing to disclose.
Gustavo A. Chiriboga Mr. Chiriboga has nothing to disclose.
Alexander J. Van Dam Mr. Van Dam has nothing to disclose.
Shubhangi Setia, MBBS Dr. Setia has nothing to disclose.
Sebastian Sanchez Herrera, MD Sebastian Sanchez Herrera has nothing to disclose.
Navami Shenoy Ms. Shenoy has nothing to disclose.
Edgar Samaniego, MD, FAAN (University of Iowa Hospital and Clinics) Dr. Samaniego has received personal compensation for serving as an employee of University of Iowa. Dr. Samaniego has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Terumo Neuro. Dr. Samaniego has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Rapid Medical. Dr. Samaniego has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for J&J Neuro. Dr. Samaniego has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Metronic. Dr. Samaniego has received personal compensation in the range of $0-$499 for serving as a Consultant for iSchemaView. Dr. Samaniego has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Society of Neurointerventional Surgery. Dr. Samaniego has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Neurointerventional Surgery.