Pre-operative prediction of cerebral hemodynamics for cognitive dysfunction in adults with Moyamoya Disease based on 3D-pCASL and radiomics

Motivation: Cognitive function in adult patients with moyamoya disease (MMD) is often impaired because of low cerebral perfusion. Goal(s): To identify brain regions where low CBF is associated with cognitive dysfunction and assess the predictive performance of radiomics models for cognitive dysfunction in adults MMD. Approach: 3D-pCASL and logistic regression analysis was employed to quantify CBF and explore independent predictors for preoperative cognitive dysfunction. And five different classifiers were used to establish radiomics models. Results: Cerebral perfusion in the left LOFL, left IPL, left SMA, and left ACG showed significant associations with cognitive impairment. The final combined model had the best predictive performance. Impact: Hypoperfusion on 3D-pCASL plays a crucial role in the detection of early cognitive impairment in adults with MMD, and the combined model that combined with CBF and radiomics features of specific brain regions showed better performance in predicting cognitive dysfunction.