Abstract Details

Title Automated Contusion Volume Measurements from Acute Phase CT Predict Post-traumatic Epilepsy

Topic Neuro Trauma and Critical Care

Presentation(s) S17 - Neurocritical Care (1:36 PM-1:48 PM)

Poster/Presentation
Number 004

Background PTE is a long-term complication of traumatic brain injury (TBI). CT is the most commonly used neuroimaging modality following acute TBI, and prior studies have linked larger contusions on CT, such as hemorrhage and edema, to a higher risk of PTE. However, manual segmentation of these contusions is time-consuming and requires skilled professionals. By leveraging a CNN-based algorithm, we aim to evaluate the predictive value of automated contusion calculations for PTE prediction.

Objective Evaluate whether convolutional neural network (CNN)-based automated quantitative contusion measurements can predict the development of post-traumatic epilepsy (PTE).

Design/Methods We retrospectively identified and matched 50 PTE patients with 50 non-PTE controls based on TBI severity (GCS at admission), age, and sex. We obtained clinical variables and CT images from patients at admission and at the time hemorrhagic stability was first noted. Utilizing the CNN-based algorithm Blast-CT (2020), we automatically measured volumes for intraparenchymal hemorrhage (IPH), edema, intraventricular hemorrhage (IVH), and extra-axial hemorrhage (EAH) from admission and stability CTs. We performed univariate logistic regressions on clinical and neuroimaging variables; all univariable features p<0.1 were incorporated into a multivariate logistic regression model. Finally, we used leave-one-out cross-validation to evaluate our model’s performance.

Results Our univariate analysis showed that early seizures (p=0.01), neurosurgical intervention within the first 7 days of injury (p<0.01), IPH volume on admission (p=0.02) and edema volume on admission (p<0.01) were associated with PTE. Univariable analyses of images at time of hemorrhage stability also showed IPH volume (p<0.01), edema (p<0.01), and combined IPH+edema (p<0.01) were significantly associated with PTE. Our multivariate model resulted in an AUC of 0.73 (95%CI:0.63–0.83).

Conclusions Our results show that automatically measured contusion volumes from acute CT images can predict PTE. Future studies with larger cohorts and comparison with other algorithms are needed to valid our model.

Authors/Disclosures
Bilal Berke Ayvaz, MD PRESENTER	Dr. Ayvaz has nothing to disclose.
Justin R. Wheelock	Mr. Wheelock has nothing to disclose.
Daniel Jin	Mr. Jin has nothing to disclose.
Jenna Appleton, PA	Ms. Appleton has nothing to disclose.
Muhammad Arsalan Bashir, MBBS	Dr. Bashir has nothing to disclose.
Khai Theeng Chow (Yale School of Medicine)	No disclosure on file
Tyler M. Frantz, High School Student	Mr. Frantz has nothing to disclose.
Samuel Snider, MD (Massachusetts General Hospital, Brigham, Harvard)	Dr. Snider has nothing to disclose.
Lawrence J. Hirsch, MD, FAAN (Yale University Comprehensive Epilepsy Center)	Dr. Hirsch has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Ceribell. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for marinus. The institution of Dr. Hirsch has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Natus. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurelis. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Rapport Therapeutics. Dr. Hirsch has received publishing royalties from a publication relating to health care. Dr. Hirsch has received publishing royalties from a publication relating to health care. Dr. Hirsch has received personal compensation in the range of $5,000-$9,999 for serving as a Speaker; Faculty for Fellows' training course with Neuropace. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Natus.
Adithya Sivaraju, MD (Yale New Haven Medical Center)	Dr. Sivaraju has nothing to disclose.
M. B. Westover, MD, PhD (MGH)	Dr. Westover has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Beacon Biosignals. Dr. Westover has stock in Beacon Biosignals. The institution of Dr. Westover has received research support from NIH. Dr. Westover has received publishing royalties from a publication relating to health care. Dr. Westover has a non-compensated relationship as a cofounder with Beacon Biosignals that is relevant to AAN interests or activities.
Sahar Zafar, MD	Dr. Zafar has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. Dr. Zafar has received research support from NIH. Dr. Zafar has received personal compensation in the range of $5,000-$9,999 for serving as a Speaker for a lecture with Marinus.
Aaron F. Struck, MD	The institution of Dr. Struck has received research support from Ceribell.
Sacit Bulent Omay (Yale Univ)	Sacit Bulent Omay has nothing to disclose.
Brian Edlow, MD	Dr. Edlow has received research support from NIH.
Emily J. Gilmore, MD (Yale University School of Medicine)	Dr. Gilmore has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for carpl.ai. Dr. Gilmore has received personal compensation in the range of $0-$499 for serving as a Consultant for AAN. Dr. Gilmore has received research support from NIH.
Jennifer A. Kim, MD (Yale University School of Medicine)	Dr. Kim has nothing to disclose.

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