Evidence map›Paper›PMID 41542736›Full record

ArticleAnnals of neurology2026

Clot Composition Profiling in Large Vessel Occlusion Stroke Via Radiomics.

Andres Gudino, Elena Sagues, Carlos Dier, Diego Ojeda, Samantha Saenz-Hinojosa, Sebastian Sanchez, Ariel Vargas, Linder Wendt, Maria Belen Torres, Emily Garces and 14 more

Abstract read
In one paragraph

Article in Annals of neurology, 2026. 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. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Andres GudinoDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Elena SaguesDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Carlos DierDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Diego OjedaDepartment of Neurology, University of Connecticut, Farmington, CT, USA.
Samantha Saenz-HinojosaDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Sebastian SanchezDepartment of Neurology, Yale University, New Haven, CT, USA.
Ariel VargasDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Linder WendtInstitution for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA.
Maria Belen TorresDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Emily GarcesDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Alex HansonDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Navami ShenoyDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Connor AamotDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Susan A WalshIowa Institute for Biomedical Imaging, University of Iowa, Iowa City, IA, USA.
Anil K ChauhanDepartment of Internal Medicine-Hematology, Oncology, University of Iowa, Iowa City, IA, USA.
Gowri Anil-PeethambarDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Santiago Ortega-GutierrezDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Jay KinariwalaDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Mohamed ElshikhDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.ORCID 0000-0003-0106-3647
Amir ShabanDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Enrique C LeiraDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.ORCID 0000-0003-3695-2946
Osorio Lopes Abath NetoDepartment of Pathology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Malik GhannamDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Edgar A SamaniegoDepartment of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveClot composition may offer insights into the mechanism of ischemic stroke. Radiomics, a noninvasive imaging technique, enables tissue characterization through radiomic features (RFs). We aimed to evaluate clot composition using radiomics on non-contrast computed tomography (NCCT).

methodsIn the first phase, we conducted a prospective study comparing RFs with histopathology in thrombi retrieved via mechanical thrombectomy (MT). Thrombi were imaged using micro-computed tomography (micro-CT) and analyzed histologically. Matched micro-CT and histological slices identified red blood cells (RBCs) and fibrin-rich regions. RFs were extracted, and multivariate logistic regression identified features associated with each component. Spearman's correlation was used to assess associations between RFs and percentage composition. The same clots were localized on pre-MT NCCT, and RFs were extracted. Micro-CT and NCCT RFs were correlated to enable histology-informed interpretation. Receiver operating characteristic analysis evaluated the ability of NCCT RFs to discriminate clot composition. In the second phase, radiomics was applied to a retrospective NCCT dataset from patients with ischemic stroke with varying etiologies.

resultsTen thrombi were analyzed using micro-CT. Total energy (odds ratio [OR] = 1.35, 95% confidence interval [CI] = 1.20-1.54, p < 0.001) and large dependence high gray level emphasis (OR = 1.18, 95% CI = 1.07-1.32, p = 0.01) were associated with RBCs and correlated with >70% RBCs composition on NCCT (Rho = 0.752 and Rho = 0.815). Subsequently, 150 NCCT scans were analyzed, including 50 cardioembolic, 50 large artery atherosclerosis (LAA), and 50 cryptogenic strokes. Radiomic analysis indicated RBCs-predominant composition in 72% of cardioembolic, 30% of LAA, and 50% of cryptogenic clots.

interpretationRadiomics is a promising, noninvasive technique for characterizing clot composition. ANN NEUROL 2026;99:1179-1188.

Indexed as

Ischemic StrokeStrokeThrombosisAgedFemaleHumansMaleMiddle AgedProspective StudiesRadiomicsRetrospective StudiesThrombectomyX-Ray Microtomography

Identifiers

PMID41542736
PMCPMC13092787

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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.