ORIGINAL RESEARCH article
Front. Neurol.
Sec. Applied Neuroimaging
Predicting 90-Day Postoperative Outcomes in Spontaneous Supratentorial Intracerebral Hemorrhage: A Double-center Study of Clinical-Radiomics Integration Using Non-Contrast CT
Provisionally accepted
- 1People's Hospital of Linshui County, Guang'an, China
- 2People’s Hospital of Linshui County, Guang’an, China
- 3The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- 4Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
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Objective: To evaluate the clinical utility of integrating baseline non-contrast computed tomography (NCCT) radiomics with clinical and surgical parameters for predicting 90-day postoperative functional outcomes in patients with spontaneous supratentorial intracerebral hemorrhage (sICH). Materials and Methods: We retrospectively analyzed data from 220 patients with sICH who underwent surgical treatment from January 2022 to January 2025. Patients from Center 1 (n=154) formed the training cohort, and those from Center 2 (n=66) served as the validation cohort. Functional outcomes at 90 days were stratified using the modified Rankin Scale. Independent clinical risk factors were identified via univariate and multivariate analyses to construct a clinical model. Radiomics features extracted from baseline NCCT images were screened using elastic net regression with 10-fold cross-validation to generate a radiomics score (Radscore). A combined model was constructed by integrating Radscore into the clinical model, and its performance was evaluated using receiver operating characteristic curves, with visualization as a nomogram. Results: Six independent clinical risk factors (age, hydrocephalus, brain herniation, hematoma location, hematoma volume, surgical duration) and three optimal radiomics features (Flatness, Least axis length, VolumeCC) were identified. The combined model achieved the highest area under the receiver operating characteristic curve values: 0.882 in the training cohort and 0.865 in the validation cohort, outperforming the clinical model (0.844, 0.830) and Radscore (0.769, 0.743). Conclusion: NCCT radiomics integrated with clinical parameters effectively predicts 90-day postoperative outcomes in sICH. The combined model, visualized as a nomogram, aids preoperative risk stratification and personalized treatment.
Keywords: Spontaneous intracerebral hemorrhage, Radiomics, Non-contrast computed tomography, prognosis, postoperative
Received: 11 Aug 2025; Accepted: 03 Dec 2025.
Copyright: © 2025 Jiang, Zhou, Wang, Xu and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhiming Zhou
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