A clinical-radiomics based nomogram to predict progressive intraparenchymal hemorrhage in mild to moderate traumatic injury patients

Purpose: To develop a non-contrast computed tomography(NCCT)based radiomics model for predicting intra-parenchymal hemorrhage progression in patients with mild to moderate traumatic brain injury(TBI).Methods: We retrospectively analyzed 166 mild to moderate TBI patients with intraparenchymal hemorrhage from January 2018 to December 2021. The enrolled patients were divided into training cohort and test cohort with a ratio of 6:4. Uni-and multivariable logistic regression analyses were implemented to screen clinical-radiological factors and to establish a clinical-radiological model. Model performance was evaluated by the area under the receiver operating characteristic curve (AUC), the calibration curve, the decision curve analysis, sensitivity, and specificity.Results: Eleven radiomics features, presence with SDH, and D-dimer > 5 mg/l were selected to construct the combined clinical-radiomic model for the prediction of TICH in mild to moderate TBI patients. The AUC of the combined model was 0.81(95% confidence interval (CI), 0.72 to 0.90) in the training cohort and 0.88 (95% CI 0.79 to 0.96) in the test cohort, which were superior to the clinical model alone (AUCtraining = 0.72, AUCtest = 0.74). The calibration curve demonstrated that the radiomics nomogram had a good agreement be-tween prediction and observation. Decision curve analysis confirmed clinically useful.Conclusions: The combined clinical-radiomic model that incorporates the radiomics score and clinical risk factors can serve as a reliable and powerful tool for Predicting intraparenchymal hemorrhage progression for patients with mild to moderate TBI.