Evidence map›Paper›PMID 41432373›Full record

ArticleeLife2025

Predictive modeling of hematoma expansion from non-contrast computed tomography in spontaneous intracerebral hemorrhage patients.

Natasha Ironside, Kareem El Naamani, Tanvir Rizvi, Mohammed Shifat El-Rabbi, Shinjini Kundu, Andrea Becceril-Gaitan, Kristofor Pas, M Harrison Snyder, Ching-Jen Chen, Carl Langefeld and 6 more

Abstract readMulticenter Study
In one paragraph

Article in eLife, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Natasha IronsideDepartment of Neurological Surgery, University of Virginia Health System, Charlottesville, United States.ORCID https://orcid.org/0009-0006-3130-5829
Kareem El NaamaniDepartment of Neurological Surgery, Thomas Jefferson University, Philadelphia, United States.
Tanvir RizviDepartment of Radiology, University of Virginia Health System, Charlottesville, United States.
Mohammed Shifat El-RabbiDepartment of Electrical and Computer Engineering, North South University, Dhaka, Bangladesh.
Shinjini KunduDepartment of Radiology, Washington University in St. Louis, St. Louis, United States.
Andrea Becceril-GaitanDepartment of Neurological Surgery, University of Louisville, Louisville, United States.
Kristofor PasDepartment of Biomedical Engineering, University of Virginia Health System, Charlottesville, United States.
M Harrison SnyderDepartment of Neurological Surgery, Tufts University Medical Center, Boston, United States.ORCID https://orcid.org/0000-0001-5740-2615
Ching-Jen ChenDepartment of Neurosurgery, Catholic Health Initiative, Omaha, United States.
Carl LangefeldDepartment of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, United States.
Daniel WooDepartment of Neurology, University of Buffalo, Buffalo, United States.
Stephan A MayerDepartment of Neurology, Westchester Medical Center, Westchester, United States.
E Sander ConnollyDepartment of Neurological Surgery, Vagelos College of Physicians and Surgeons, Columbia University, New York, United States.
Gustavo Kunde RohdeDepartment of Biomedical Engineering, University of Virginia Health System, Charlottesville, United States.
VISTA-ICH
ERICH Investigators

Funding

Transport transforms for biomedical data modeling, estimation, and classificationR01GM130825 · NIGMS · UNIVERSITY OF VIRGINIA · PI Gustavo Kunde Rohde · 2019 to 2026
$2.8M
Neurosurgery Research and Education Foundation Young Clinician Investigator AwardNIGMS NIH HHS R01 GM130825NIH HHS R01GM130825-01
6 · The paper itself

Abstract

Hematoma expansion is a consistent predictor of poor neurological outcome and mortality after spontaneous intracerebral hemorrhage (ICH). An incomplete understanding of its biophysiology has limited early preventative intervention. Transport-based morphometry (TBM) is a mathematical modeling technique that uses a physically meaningful metric to quantify and visualize discriminating image features that are not readily perceptible to the human eye. We hypothesized that TBM could discover relationships between hematoma morphology on initial Non-Contrast Computed Tomography (NCCT) and hematoma expansion. 170 spontaneous ICH patients enrolled in the multi-center international Virtual International Trials of Stroke Archive (VISTA-ICH) with time-series NCCT data were used for model derivation. Its performance was assessed on a test dataset of 170 patients from the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study. A unique transport-based representation was produced from each presentation NCCT hematoma image to identify morphological features of expansion. The principal hematoma features identified by TBM were larger size, density heterogeneity, shape irregularity, and peripheral density distribution. These were consistent with clinician-identified features of hematoma expansion, corroborating the hypothesis that morphological characteristics of the hematoma promote future growth. Incorporating these traits into a multivariable model comprising morphological, spatial, and clinical information achieved an AUROC of 0.71 for quantifying 24 hr hematoma expansion risk in the test dataset. This outperformed existing clinician protocols and alternate machine learning methods, suggesting that TBM detected features with improved precision than by visual inspection alone. This pre-clinical study presents a quantitative and interpretable method for discovery and visualization of NCCT biomarkers of hematoma expansion in ICH patients. Because TBM has a direct physical meaning, its modeling of NCCT hematoma features can inform hypotheses for hematoma expansion mechanisms. It has potential future application as a clinical risk stratification tool.

Indexed as

Cerebral HemorrhageHematomaTomography, X-Ray ComputedAgedFemaleHumansMaleMiddle AgedModels, Theoreticalcomputational biologyhematoma expansionhumanintracerebral hemorrhageneurosciencepredictive modelingstrokesystems biology

Identifiers

PMID41432373
PMCPMC12726831

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.