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Objectives: To explore whether dual-energy computed tomography (DECT) angiography can provide reliable quantitative information on net water uptake (NWU) of ischemic brain to identify stroke patients within 4.5 h. Methods: We retrospectively reviewed 142 patients with stroke occurrence and who underwent DECT angiography between August 2016 and May 2022. DECT angiography manual drawn the ischemic area by referring to the normal area of the contralateral hemisphere and follow-up images. The NWU in the ischemic area was determined using virtual non-contrast and monoenergetic (VNC &VM) images acquired from DECT angiography. The NWU values in the ischemic area were compared between stroke patients within and beyond 4.5 h. The diagnostic performance of the NWU values derived from the VNC and VM images was assessed through receiver operating characteristic curve analysis. Additionally, Furthermore, we examined the correlation between the NWU values and the stroke onset time. Results: Seventy-eight (54.93 %) stroke patients underwent DECT angiography and within 4.5 h. These patients with lower median National Institute of Health stroke scale (NIHSS) scores on admission than those beyond 4.5 h (p

• DE-CTA-derived parameters could be associated with thrombus composition and allow for personalized thrombectomy strategies. • The RBC-dominant thrombi showed significantly higher VNC values and lower IC, λHU, and Z eff values than the F/P-dominant thrombi (p < 0.05). • The thrombus composition was associated with DE-CTA-derived parameters. We aimed to assess the value of dual-energy computed tomography angiography (DE-CTA) derived parameters as a quantitative biomarker of thrombus composition in acute ischemic stroke (AIS). AIS patients who underwent DE-CTA before thrombectomy between August 2016 and September 2022 were included in this study. We assessed the relative proportion of red blood cells (RBCs) and the fibrin/platelet ratio (F/P) of the retrieved clots and categorized the clots as RBC-dominant (RBCs > F/P) or F/P-dominant (F/P > RBCs). The thrombus based parameters were measured on polyenergetic images (PEI), virtual monoenergetic (VM), virtual non-contrast (VNC), iodine concentration (IC), and effective atomic number (Z eff) images respectively, and the slope of the spectral Hounsfield unit curve (λHU) was calculated. These parameters were compared in the DE-CTA images of RBC- and F/P-dominant thrombi. The diagnostic performance of the parameters was analyzed using the ROC curve. Correlations between thrombus composition and DE-CTA-derived parameters were assessed. The retrieved clots in 54 of 88 patients (61.36%) were RBC-dominant. The RBC-dominant thrombi showed significantly higher VNC values and lower IC, λHU, and Z eff values than the F/P-dominant thrombi (p < 0.05). The CT density measured on IC images showed the largest AUC value (AUC, 0.94; sensitivity, 77.78%; specificity, 100.00%). The Spearman rank-order correlation coefficient values showed that CT density measured on IC images of the thrombus showed the strongest association with the proportion of RBCs (r = -0.64, p < 0.001) and F/P (r = 0.65, p < 0.001). DE-CTA-derived parameters, especially the CT density measured on IC images, could be associated with thrombus composition and allow for personalized thrombectomy strategies. [ABSTRACT FROM AUTHOR]

Objective: To develop and externally validate a CT‐based radiomics nomogram for the pre‐operative prediction of lymphovascular invasion (LVI) in patients with colorectal cancer (CRC). Methods: 357 patients derived from 2 centers with pathologically confirmed CRC were included in this retrospective study. Two‐dimensional (2D) and three‐dimensional (3D) radiomics features were extracted from portal venous phase CT images. The least absolute shrinkage and selection operator algorithm and logistic regression were used for constructing 2D and 3D radiomics models. The radiomics nomogram was developed by integrating the radiomics score (rad‐score) and the clinical risk factor. Results: The rad‐score was significantly higher in the LVI+ group than in the LVI‐ group (p < 0.05). The area under the curve (AUC), accuracy, sensitivity and specificity of the 3D radiomics model were higher than those of the 2D radiomics model. The AUCs of 3D and 2D radiomics models in the training set were 0.82 (95% CI: 0.75–0.89) and 0.74 (95% CI: 0.66–0.82); in the internal validation set were 0.75 (95% CI: 0.65–0.85) and 0.67 (95% CI: 0.56–0.78); in the external validation set were 0.75 (95% CI: 0.64–0.86) and 0.57 (95% CI: 0.45–0.69); respectively. The AUCs of the nomogram integrating the optimal 3D rad‐score and clinical risk factors (CT‐reported T stage, CT‐reported lymph node status) in the internal set and external validation set were 0.82 (95% CI: 0.73–0.91) and 0.80 (95% CI: 0.68–0.91), respectively. Conclusion: Both 2D and 3D radiomics models can predict LVI status of CRC. The nomogram combining the optimal 3D rad‐score and clinical risk factors further improved predictive performance. Advances in knowledge: This is the first study to compare the difference in performance of CT‐based 2D and 3D radiomics models for the pre‐operative prediction of LVI in CRC. The prediction of the nomogram could be improved by combining the 3D radiomics model with the imaging model, suggesting its potential for clinical application. [ABSTRACT FROM AUTHOR]

• Radiomics features from combined intrathrombus and perithrombus regions enhance the predictive accuracy of intracranial hemorrhage risk following endovascular thrombectomy. • Our radiomic models provide valuable insights for optimizing clinical decision-making post-endovascular thrombectomy. • The robustness of radiomic approach is confirmed through successful multicenter validation. This study aimed to assess the predictive performance of radiomics derived from computed tomography (CT) images of thrombus regions in predicting the risk of intracranial hemorrhage (ICH) following endovascular thrombectomy (EVT). This retrospective multicenter study included 336 patients who underwent admission CT and EVT for acute anterior-circulation large vessel occlusion between December 2018 and December 2023. Follow-up imaging was performed 24 h post-procedure to evaluate the occurrence of ICH. 230 patients from centers A and B were randomly allocated into training and test groups in a 7:3 ratio, while the remaining 106 patients from center C comprised the validation cohort. Radiologists manually segmenting the thrombus on CT images, and the perithrombus region was defined by expanding the initial region of interest (ROI). A total of 428 radiomics features were extracted from both intrathrombus and perithrombus regions on CT images. The Mann–Whitney U test was used for feature selection, and least absolute shrinkage and selection operator (LASSO) regression was employed for model development, followed by validation using a 5-fold cross-validation approach. Model performance was assessed using the area under the curve (AUC) of the receiver operating characteristic (ROC). Among the eligible patients, 128 (38.1 %) experienced ICH after EVT. The combined model exhibited superior performance in the training cohort (AUC: 0.913, 95 % CI: 0.861–0.965), test cohort (AUC: 0.868, 95 % CI: 0.775–0.962), and validation cohort (AUC: 0.850, 95 % CI: 0.768–0.912). Notably, in the validation group, both the perithrombus and combined models demonstrated higher predictive accuracy compared to the intrathrombus model (0.837 vs. 0.684, p = 0.02; AUC: 0.850 vs. 0.684, p = 0.01). Radiomics features derived from the perithrombus region significantly enhance the prediction of ICH after EVT, providing valuable insights for optimizing post-procedural clinical decisions. This study highlights the importance of radiomics extracted from intrathrombus and perithrombus region in predicting intracranial hemorrhage following endovascular thrombectomy, which can aid in improving patient outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to assess the relationship and prognostic significance between preoperative serum albumin to globulin ratio (AGR) and high-resolution computed tomography (HRCT) features of non-small cell lung cancer (NSCLC).Materials and Methods: Demographic parameters, laboratory values including AGR and other clinical variables were evaluated in 180 patients with NSCLC, and 72 of these patients had results of radiology parameters detected with HRCT [including emphysema, tumor disappearance rate (TDR), CT values and CT enhanced values of the tumor mass] were assessed for survival analyses. The 72 patients were divided into two groups: normal lung group and emphysema group. The discriminatory values for AGR between these two groups were assessed by Mann-Whitney U test The relationship between TDR and AGR in NSCLC patients was evaluated by Pearson correlation analysis.Results: In multivariate analysis, TDR (p = 0.033), AGR (p = 0.038), emphysema (p = 0.009), and N stage (P = 0.026) were independent predictors of overall survival (OS). AGR was higher in NSCLC patients without emphysema than NSCLC patients with emphysema (z = -2.979, P = 0.003). TDR demonstrated that there was a positive relationship with AGR (r = 0.307, p = 0.009). A nomogram with AGR, TDR, emphysema, and N stage was established to predict 5-year survival.Conclusions: There is a relationship between CT features and AGR in NSCLC. The integrative nomogram combined with CT images, clinical and hematologic features improved survival prediction in NSCLC patients, which offers a non-invasive, comprehensive, and convenient evaluation for individualized management of NSCLC patients. [ABSTRACT FROM AUTHOR]