Prediction of Anemia From Cerebral Venous Sinus Attenuation on Deep-Learning Reconstructed Brain Computed Tomography Images

The aim of the study is to evaluate whether the prediction of anemia is possible using quantitative analyses of unenhanced cranial computed tomography (CT) with deep learning reconstruction (DLR) compared with conventional methods.This cross-sectional retrospective study included 116 participants (76 males; mean age, 66.7) who had hemoglobin (Hb) levels obtained within 24 hours of unenhanced cranial CT, which included 2 reconstruction methods: DLR and hybrid iterative reconstruction. Regions of interest were the confluence of sinuses (CoS) and the right and left transverse sinuses. In addition, edge rise distance of cerebrospinal fluid and venous was measured.Spearman rank correlation coefficient demonstrated a positive association between Hb levels and sinus attenuation values. Among these, the CoS in DLR had the best correlation ( r = 0.703, P < 0.001). For the prediction of anemia (Hb < 11 g/dL), the area under the curve of CoS in DLR (area under the curve = 0.874; 95% confidence interval, 0.798-0.949; P < 0.001) was the highest; however, there were no significant differences among reconstruction method and sinus. The attenuation values of DLR were significantly higher than those of hybrid iterative reconstruction ( P < 0.001, paired t test), and the differences between the 2 methods were 4.1 (standard deviation [SD], 1.6) for CoS, 5.2 (SD, 2.2) for right transverse sinuses, and 5.8 (SD, 2.4) for left transverse sinuses. The signal-to-noise ratio ( P < 0.001, paired t test) and edge rise distance ( P < 0.001, Wilcoxon signed rank test) of DLR was significantly higher.Higher CT attenuation values should be considered for predicting anemia based on brain DLR images.