Abstract 038: Radiomic Profiling of High‐Risk Aneurysms with Blebs

IntroductionThe presence of aneurysm blebs significantly increases the risk of rupture. Although radiomics has been previously utilized to assess intracranial aneurysms (IAs), the radiomic profiling (RP) of different compartments within aneurysms remains unexplored. This exploratory study aimed to investigate the RP of aneurysms with blebs and to analyze the interplay between radiomic features (RFs) and biomechanical analysis within the blebs, including wall tension (WT) and wall shear stress (WSS) metrics.MethodsAfter Institutional Review Board approval, IAs were analyzed using high‐resolution magnetic resonance imaging (HR‐MRI). Blebs were adjudicated as focal outpouchings within the body of the aneurysms on angiographic studies and colocalized on HR‐MRI. 3D Slicer was utilized to generate 3D models of the aneurysm bodies and blebs, and RFs were extracted independently for the body and bleb in T1Gd (figure 1). A previously described pipeline involving finite element analysis, and computational fluid dynamics was employed to compute WT and WSS metrics. Univariate regression models comparing the blebs and bodies of the same aneurysms were constructed to determine which RFs were different between the bleb and body sac of the same aneurysms. Finally, spearman's correlations were fit between the bleb's RFs and WT and WSS metrics.ResultsEighteen aneurysms with blebs (16%, 18/114) were identified. Fifty‐five RFs were significantly different between the blebs and the bodies of the same aneurysms. Among these RFs, 28% (5/18) were first‐order RFs, while 68% (50/75) were second‐order RFs. Forty‐one out of the 55 different RFs exhibited strong or moderate correlations with low wall shear stress (WSS) and a high oscillatory shear index (OSI). A more heterogeneous vessel wall and a varied distribution of voxel signal intensities within the bleb's vessel wall were associated with low WSS and high OSI.ConclusionAneurysm blebs exhibit unique RP compared to the body sacs of aneurysms. The heterogeneity of the bleb walls may result from distinct mechanical loads and focal hemodynamics. RP holds promise for analyzing areas of elevated risk within unruptured aneurysms.