Prof. Dong-Joo Kim's new research, Abilities of a Densitometric Analysis of Computed Tomography Images and Hemorrhagic Parameters to Predict Outcome Favorability in Patients with Intracerebral Hemorrhagewas accepted in Neurosurgery.
Title: Abilities of a Densitometric Analysis of Computed Tomography Images and Hemorrhagic Parameters to Predict Outcome Favorability in Patients with Intracerebral Hemorrhage
- Background: Intracerebral hemorrhage (ICH) is one of the most devastating subtypes of stroke. A rapid assessment of ICH severity involves the use of computed tomography (CT) and derivation of the hemorrhage volume, which is often estimated using the ABC/2 method. However, these estimates are highly inaccurate and may not be feasible for anticipating outcome favorability.
- Objective: This study sought to predict patient outcomes via a quantitative, densitometric analysis of CT images and to compare the predictive power of these densitometric parameters with the conventional ABC/2 volumetric parameter and segmented hemorrhage volumes.
- Methods: Non-contrast CT images of 87 adult patients with ICH (favorable outcomes=69, unfavorable outcomes=12, and deceased=6) were analyzed. In-house software was used to calculate the segmented hemorrhage volumes, ABC/2 and densitometric parameters, including the skewness and kurtosis of the density distribution, interquartile ranges and proportions of specific pixels in sets of CT images. Non-parametric statistical analyses were conducted.
- Results: The densitometric parameter interquartile range exhibited greatest accuracy (82.7%) in predicting favorable outcomes. The combination of skewness and the interquartile range effectively predicted mortality (accuracy=83.3%). The actual volume of the ICH exhibited good coherence with ABC/2 (R=0.79). Both parameters predicted mortality with moderate accuracy (<78%) but were less effective in predicting unfavorable outcomes.
- Conclusion: Hemorrhage volume was rapidly estimated and effectively predicted mortality in patients with ICH; however, this value may not be useful for predicting favorable outcomes. The densitometric analysis exhibited significantly higher power in predicting mortality and favorable outcomes in patients with ICH.