Contrast-enhanced CT Texture Parameters as Predictive Markers of High-risk Urodynamic Features in Adult Patients with Spina Bifida

Urology. 2019 Dec:134:84-89. doi: 10.1016/j.urology.2019.09.023. Epub 2019 Oct 1.

Abstract

Objective: To investigate computed tomography (CT) texture analysis of the bladder wall as a predictor of urodynamics findings in adult patient with spina bifida.

Methods: A single-center prospective trial was conducted from March 2015 to March 2017 including all consecutive adult spina bifida patients seen for urodynamic testing. A contrast-enhanced abdominal CT was systematically performed in all patients during the same visit. Texture features of the bladder wall related to the gray-level histogram and gray-level co-occurrence were evaluated on CT images. Multivariate analysis was performed to identify independent predictors of poor bladder compliance and detrusor overactivity among clinical and texture parameters.

Results: Fourty patients were included. The Lasso penalized logistic regression analysis identified 2 texture parameters as potential predictors of poor bladder compliance: Skewness (coefficient weight, -1.81) and S.1.1.SumVarnc (coefficient weight, -3.52). Multivariate logistic regression analysis confirmed skewness (odds ratio [confidence interval 95%] = 0.40 [0.14, 0.97], P = .04) as an independent predictor of poor bladder compliance. The Lasso penalized logistic regression analysis identified one texture parameters as potential predictor of detrusor overactivity: Kurtosis (coefficient weight, -3.52), which was confirmed in multivariate logistic regression analysis (odds ratio [confidence interval 95%] = 1.12 [1.01, 1.55], P = .02).

Conclusion: Our findings demonstrate that CT texture analysis of the bladder wall might be an interesting tool to identify spina bifida patients with high risk urodynamic features.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Female
  • France
  • Humans
  • Male
  • Prospective Studies
  • Radiographic Image Enhancement / methods
  • Spinal Dysraphism* / complications
  • Spinal Dysraphism* / diagnosis
  • Spinal Dysraphism* / physiopathology
  • Tomography, X-Ray Computed / methods*
  • Urinary Bladder* / diagnostic imaging
  • Urinary Bladder* / physiopathology
  • Urinary Bladder, Overactive* / diagnosis
  • Urinary Bladder, Overactive* / etiology
  • Urinary Bladder, Overactive* / physiopathology
  • Urodynamics*