Comparison of Non-Contrasted Cranial Computerized Tomographic Images With No Early Radiological Signs and Findings of Ischemic Stroke Patients and The Counterpart Normal Brain Parenchyma Over “Radiomics” Parameters

Abstract

Purpose: The purpose of this study was to evaluate the non-contrasted cranial computerized tomography images of ischemic stroke patients with no early radiological signs and findings with texture-tissue analysis over radiomics parameters; and to obtain quantitative data that may contribute to the diagnosis of ischemic stroke.

Materials and Methods: In the present study of ours, the diffusion magnetic resonance imaging (MRI) and non-contrasted computerized tomography (CT) scans of the patients who were admitted to the Emergency Department with clinical symptoms of stroke were reviewed retrospectively. A total of 37 patients (19 females, 18 males) who were between 54-96 years of age, who had diffusion limitation that was consistent with acute ischemic infarction in MR scans, and who did not have early radiological findings and signs in non-contrasted CT scans were included in the study. In the CT images, the infarct area and itscounterpart in the other hemisphere were marked manually with a 1 cm-diameter ROI circle based on Diffusion Sequences and ADC Maps. A total of 106 tissue analysis parameters were obtained with the radiomics add-on of the 3DSlicer Program. A total of 21 parameters that were commonly used in the literature were recorded for statistical evaluation by reviewing similar studies in the literature.
Findings: The following significant differences were found in parameters; glcmjointavarage, glcmjointenergy, glcmcontrast, firstorderuniformity, firstordermedian, firstorderenergy, firstordermax, firstordermean, glrlmrunlengthnonuiformty and ngtdmcontrast. The most significant parameter was ngtdmcontrast: It was found as the parameter, which showed the frequency of gray level variability together with the dynamic range of grayscale levels that showedthe contrast.

Result: In the non-contrasted CT examination, the changes in the parameters of the infarct area appeared in the tissue analysis in the time period when no early radiological findings and signs of stroke were detected.