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Perfusion And Permeability Imaging as Diagnostic And Prognostic Biomarkers of Cavernous Angioma with Symptomatic Hemorrhage
Je Yeong Sone1, Yan Li1,2, Nicholas Hobson1, Sharbel G. Romanos1, Abhinav Srinath1, Seán B. Lyne1, Abdallah Shkoukani1, Julián Carrión-Penagos1, Agnieszka Stadnik1, Kristina Piedad1, Rhonda Lightle1, Thomas Moore1, Ying Li1, Dehua Bi1,3, Timothy Carroll4, Yuan Ji3, Romuald Girard1, and Issam A. Awad1
1Neurovascular Surgery Program, Section of Neurosurgery, Department of Surgery, University of Chicago Medicine and Biological Sciences, Chicago, IL, United States, 2Bioinformatics Core, Center for Research Informatics, The University of Chicago, Chicago, IL, United States, 3Department of Public Health Sciences, The University of Chicago, Chicago, IL, United States, 4Department of Diagnostic Radiology, University of Chicago Medicine and Biological Sciences, Chicago, IL, United States
Perfusion derivations helped distinguish CASH 3–12 months prior with 80% sensitivity and 82% specificity. A combination of permeability and perfusion derivations predicted subsequent CA bleeding/growth with 77% sensitivity and 72% specificity.
Figure 1. The best diagnostic biomarker of CASH 3–12 months prior to DCEQP imaging. (A) Weighted βi coefficients of covariates (all p<0.05) in the perfusion biomarker of CASH 3–12 months prior; error bars are SE. (B) The biomarker distinguished CASH 3–12 months prior (AUC=0.86, p<0.0001) better than entropy (AUC=0.62, p=0.003) or skewness (AUC=0.62, p=0.003) alone. Abbreviations: area under the curve (AUC), cavernous angioma with symptomatic hemorrhage (CASH), dynamic contrast-enhanced quantitative perfusion (DCEQP); standard error (SE).
Figure 2. The best prognostic biomarker of bleeding/growth within a year after DCEQP imaging. (A) Weighted βi coefficients of covariates (all p<0.05) in the prognostic biomarker; error bars are SE. One outlier (studentized residual>3) was excluded. (B) The biomarker (AUC=0.80, p<0.0001) predicted bleeding/growth better than mean permeability (AUC=0.65, p=0.019) or low-perfusion cluster mean (AUC=0.67, p=0.007) alone. Abbreviations: area under the curve (AUC), dynamic contrast-enhanced quantitative perfusion (DCEQP); standard error (SE).