• Nima Alan, Serafettin Zenkin, Raj Swaroop Lavadi, Andrew D Legarreta, Joseph S Hudson, Daryl P Fields, Nitin Agarwal, Priyadarshini Mamindla, Murat Ak, Vishal Peddagangireddy, Lauren Puccio, Thomas J Buell, D Kojo Hamilton, Adam S Kanter, David O Okonkwo, Pascal O Zinn, and Rivka R Colen.
• Department of Neurological Surgery, University of California, San Francisco, San Francisco, California. Electronic address: nima.alan@ucsf.edu.
• World Neurosurg. 2024 Apr 1; 184: e137e143e137-e143.

BackgroundPreoperative symptom severity in cervical spondylotic myelopathy (CSM) can be variable. Radiomic signatures could provide an imaging biomarker for symptom severity in CSM. This study utilizes radiomic signatures of T1-weighted and T2-weighted magnetic resonance imaging images to correlate with preoperative symptom severity based on modified Japanese Orthopaedic Association (mJOA) scores for patients with CSM.MethodsSixty-two patients with CSM were identified. Preoperative T1-weighted and T2-weighted magnetic resonance imaging images for each patient were segmented from C2-C7. A total of 205 texture features were extracted from each volume of interest. After feature normalization, each second-order feature was further subdivided to yield a total of 400 features from each volume of interest for analysis. Supervised machine learning was used to build radiomic models.ResultsThe patient cohort had a median mJOA preoperative score of 13; of which, 30 patients had a score of >13 (low severity) and 32 patients had a score of ≤13 (high severity). Radiomic analysis of T2-weighted imaging resulted in 4 radiomic signatures that correlated with preoperative mJOA with a sensitivity, specificity, and accuracy of 78%, 89%, and 83%, respectively (P < 0.004). The area under the curve value for the ROC curves were 0.69, 0.70, and 0.77 for models generated by independent T1 texture features, T1 and T2 texture features in combination, and independent T2 texture features, respectively.ConclusionsRadiomic models correlate with preoperative mJOA scores using T2 texture features in patients with CSM. This may serve as a surrogate, objective imaging biomarker to measure the preoperative functional status of patients.Copyright © 2024. Published by Elsevier Inc.

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