RADAR - Radiomics on aSDH: predicting outcome with surface area

Area of Science:

• Neurosurgery
• Radiology
• Medical Imaging Analysis

Background:

• Acute subdural hematoma (aSDH) presents a critical neurosurgical challenge with significant morbidity and mortality.
• Limited clinical improvement post-evacuation necessitates better decision-making tools for surgical intervention.
• Radiomics can extract complex imaging patterns to reflect pathophysiology and aid in decision support.

Purpose of the Study:

• To analyze radiomic parameters of aSDH to guide decisions between urgent surgery and conservative management.
• To investigate the predictive value of radiomic features, specifically surface area, for neurological outcomes and survival rates.

Main Methods:

• Retrospective radiomic analysis of aSDH patients.
• Measurement of radiomic parameters using 3D Slicer software.
• Statistical analyses included correlation, AUC-analysis, and Kaplan-Meier survival analysis.

Main Results:

• Significant correlations were found between hematoma surface area and poorer neurological prognosis.
• Surface area significantly predicted poorer outcomes in patients undergoing craniotomy (p < 0.05).
• Smaller surface areas (< 339.50 cm² ) were associated with advantageous survival across all management subgroups.

Conclusions:

• Hematoma surface area is a potential predictor of neurological outcome and survival in aSDH patients.
• This finding is particularly relevant for guiding treatment decisions in patients undergoing craniotomy.