Radiomics and machine learning to predict aggressive type 2 endoleaks after endovascular aneurysm repair: a proof of concept.


Journal

Acta radiologica (Stockholm, Sweden : 1987)
ISSN: 1600-0455
Titre abrégé: Acta Radiol
Pays: England
ID NLM: 8706123

Informations de publication

Date de publication:
Sep 2022
Historique:
pubmed: 28 7 2021
medline: 8 9 2022
entrez: 27 7 2021
Statut: ppublish

Résumé

Persistent type 2 endoleaks (T2EL) require lifelong surveillance to avoid potentially life-threatening complications. To evaluate the performance of radiomic features (RF) derived from computed tomography angiography (CTA), for differentiating aggressive from benign T2ELs after endovascular aneurysm repair (EVAR). A prospective study was performed on patients who underwent EVAR from January 2018 to January 2020. Analysis was performed in patients who were diagnosed with T2EL based on the CTA of the first postoperative month and were followed at six months and one year. Patients were divided into two groups according to the change of aneurysm sac dimensions. Segmentation of T2ELs was performed and RF were extracted. Feature selection for subsequent machine-learning analysis was evaluated by means of artificial intelligence. Two support vector machines (SVM) classifiers were developed to predict the aneurysm sac dimension changes at one year, utilizing RF from T2EL at one- and six-month CTA scans, respectively. Among the 944 initial RF of T2EL, 58 and 51 robust RF from the one- and six-month CTA scans, respectively, were used for the machine-learning model development. The SVM classifier trained on one-month signatures was able to predict sac expansion at one year with an area under curve (AUC) of 89.3%, presenting 78.6% specificity and 100% sensitivity. Similarly, the SVM classifier developed with six-month radiomics data showed an AUC of 95.5%, specificity of 90.9%, and sensitivity of 100%. Machine-learning algorithms utilizing CTA-derived RF may predict aggressive T2ELs leading to aneurysm sac expansion after EVAR.

Sections du résumé

BACKGROUND BACKGROUND
Persistent type 2 endoleaks (T2EL) require lifelong surveillance to avoid potentially life-threatening complications.
PURPOSE OBJECTIVE
To evaluate the performance of radiomic features (RF) derived from computed tomography angiography (CTA), for differentiating aggressive from benign T2ELs after endovascular aneurysm repair (EVAR).
MATERIAL AND METHODS METHODS
A prospective study was performed on patients who underwent EVAR from January 2018 to January 2020. Analysis was performed in patients who were diagnosed with T2EL based on the CTA of the first postoperative month and were followed at six months and one year. Patients were divided into two groups according to the change of aneurysm sac dimensions. Segmentation of T2ELs was performed and RF were extracted. Feature selection for subsequent machine-learning analysis was evaluated by means of artificial intelligence. Two support vector machines (SVM) classifiers were developed to predict the aneurysm sac dimension changes at one year, utilizing RF from T2EL at one- and six-month CTA scans, respectively.
RESULTS RESULTS
Among the 944 initial RF of T2EL, 58 and 51 robust RF from the one- and six-month CTA scans, respectively, were used for the machine-learning model development. The SVM classifier trained on one-month signatures was able to predict sac expansion at one year with an area under curve (AUC) of 89.3%, presenting 78.6% specificity and 100% sensitivity. Similarly, the SVM classifier developed with six-month radiomics data showed an AUC of 95.5%, specificity of 90.9%, and sensitivity of 100%.
CONCLUSION CONCLUSIONS
Machine-learning algorithms utilizing CTA-derived RF may predict aggressive T2ELs leading to aneurysm sac expansion after EVAR.

Identifiants

pubmed: 34313492
doi: 10.1177/02841851211032443
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1293-1299

Auteurs

Stavros Charalambous (S)

Interventional Radiology Unit, Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece.
Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece.
Department of Radiology, School of Medicine, University of Crete, Greece.

Michail E Klontzas (ME)

Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece.
Department of Radiology, School of Medicine, University of Crete, Greece.
Advanced Hybrid Imaging Systems, Institute of Computer Science, Foundation for Research and Technology (FORTH), Heraklion, Crete, Greece.

Nikolaos Kontopodis (N)

Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University Hospital of Heraklion, School of Medicine, University of Crete, Greece.

Christos V Ioannou (CV)

Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University Hospital of Heraklion, School of Medicine, University of Crete, Greece.

Kostas Perisinakis (K)

Department of Medical Physics, University Hospital of Heraklion, School of Medicine, University of Crete, Greece.

Thomas G Maris (TG)

Department of Medical Physics, University Hospital of Heraklion, School of Medicine, University of Crete, Greece.

John Damilakis (J)

Department of Medical Physics, University Hospital of Heraklion, School of Medicine, University of Crete, Greece.

Apostolos Karantanas (A)

Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece.
Department of Radiology, School of Medicine, University of Crete, Greece.
Advanced Hybrid Imaging Systems, Institute of Computer Science, Foundation for Research and Technology (FORTH), Heraklion, Crete, Greece.

Dimitrios Tsetis (D)

Interventional Radiology Unit, Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece.
Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece.
Department of Radiology, School of Medicine, University of Crete, Greece.

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