Thrombus Radiomics on Preoperative CTA Predicts Aneurysm Sac Shrinkage After EVAR

Preoperative CTA thrombus radiomics combined with clinical variables predicted sac shrinkage after EVAR with AUC 0.76, sensitivity 0.70, specificity 0.75, accuracy 0.73.

• Two radiomic features of intraluminal thrombus were significantly associated with sac shrinkage at 12 months.
• Younger age, larger aneurysm diameter, and homogeneous thrombus texture were associated with shrinkage; absence of COPD was associated with no shrinkage.
• The combined clinical-radiomic model outperformed clinical-only and radiomic-only models, but validation in larger cohorts is needed given the small single-center retrospective design (n=94).

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