Contrast-enhanced CT texture parameters as predictive markers of high-risk urodynamic features in adult patients with spina bifida

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 (PBC) and detrusor overactivity (DO) among clinical and texture parameters. Results Fourty patients were included. The Lasso penalized logistic regression analysis identified two 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 (OR (CI 95%) = 0.40 (0.14, 0.97), p = 0.04) as an independent predictor of PBC. The Lasso penalized logistic regression analysis identified one texture parameters as potential predictor of DO: Kurtosis (coefficient weight, -3.52). which was confirmed in multivariate logistic regression analysis (OR (CI 95%) = 1.12 (1.01, 1.55), p = 0.02. 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.