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CT-Derived Features as Predictors of Clot Burden and Resolution.

Quentin Auster1, Omar Almetwali2, Tong Yu3

  • 1Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15260, USA.

Bioengineering (Basel, Switzerland)
|November 27, 2024
PubMed
Summary

Cardiopulmonary and demographic factors, not body composition, predict pulmonary embolism (PE) resolution. These biomarkers can aid in managing patients post-acute PE.

Keywords:
AI algorithmsPE resolutionacute and chronic pulmonary embolism (PE)clot burden

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Area of Science:

  • Radiology
  • Pulmonary Medicine
  • Cardiology

Background:

  • Acute pulmonary embolism (PE) can lead to chronic PE, necessitating methods to predict resolution.
  • CT imaging offers potential biomarkers for assessing PE outcomes.
  • Current methods for distinguishing acute PE resolution from chronic PE progression are limited.

Purpose of the Study:

  • To assess the prognostic value of CT-derived biomarkers in predicting acute pulmonary embolism (PE) resolution versus chronic PE.
  • To determine the association of these biomarkers with initial clot burden.
  • To identify factors that can aid in patient follow-up after acute PE.

Main Methods:

  • Utilized AI algorithms to extract CT-derived features (body composition, vasculature, clot burden) from 96 scans of 45 patients with acute PE.
  • Applied Lasso regularization for parameter selection.
  • Employed Ordinary Least Squares and logistic regressions to analyze associations with clot burden and predict PE resolution.

Main Results:

  • Cardiopulmonary features, including airway ratio, aorta diameter, and heart volume, significantly correlated with PE resolution (AUC: 0.83).
  • Multivariate models using cardiopulmonary data outperformed those based solely on body composition or baseline clot burden.
  • Demographic features also showed prognostic value, comparable to cardiopulmonary factors.

Conclusions:

  • CT-derived cardiopulmonary and demographic features are valuable prognostic indicators for predicting PE resolution.
  • Body composition and initial clot burden were less effective in predicting PE outcomes.
  • Identified prognostic factors can potentially improve follow-up strategies for acute PE patients.