Abstract DP071: Radiomic Signatures on CT Imaging Representing Neutrophil Extracellular Traps in Ischemic Stroke Clots

Background: Radiomic and transcriptomic analyses have independently identified features linked to mechanical thrombectomy (MT) outcomes in acute ischemic stroke (AIS). In this study, we integrate paired radiomic and transcriptomic profiling of AIS clots to identify Neutrophil Extracellular Trap (NET) enrichment as a predictor of first-pass MT success. We further assess the potential to non-invasively detect NET enrichment using pre-thrombectomy CT imaging. Methods: We performed radiomic and transcriptomic analysis of 32 stroke clots retrieved by MT (n=16 each of modified first pass [mFP] success and failure). Clots were segmented from pre-MT CTA and nCCT scans and radiomic features (RFs) were extracted using pyRadiomics. Normality, equal variance, and two-sample testing were completed to identify which RFs were significantly different between mFP outcomes. Differentially expressed genes (DEGs) were identified between transcriptomes of mFP success and failure using the criteria of logFC≥1.5 and q