339 - Radiomic Signal Changes Following Histotripsy Ablation of Metastatic Hepatic Lesions

Wednesday, April 15, 2026

11:51 AM - 12:00 PM ET

Presenting Author(s)

Tej I. Mehta, MD (he/him/his)

Interventional Radiology Resident
Johns Hopkins Hospital, United States

Author/Co-author(s)

CH

Caleb Heiberger, MD

Radiology Resident
Johns Hopkins, United States
Tony Tae Kyung Kim, MD

Resident Physician
Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, United States
CL

Carolina Lugo-Fagundo, MD

Resident Physician
Johns Hopkins University, United States
Alec Jost, MD

Resident
Johns Hopkins Hospital, United States
KR

Kent Reichel, MD

Integrated IR/DR Resident
Johns Hopkins Hosptial, United States
Christos Georgiades, MD, PhD

Professor, Director of Interventional Oncology
Johns Hopkins University, United States

Purpose: To characterize radiomic changes between pre- and post-treatment CT imaging in patients undergoing liver histotripsy, with the goal of identifying imaging biomarkers of treatment response.

Materials and Methods: All patients who underwent histotripsy of the liver for metastatic lesions at our institution in the past year were retrospectively reviewed. Sixteen patients received attempted treatment using the Edison Histosonics system, of whom fourteen were successfully treated. Pre-treatment and approximately one-month post-treatment non-contrast CT scans were collected for the successfully treated patients. All images were resampled to 512×512×512 voxels, intensity-normalized, and spatially co-registered using affine transformation. Radiomic features were extracted using PyRadiomics and normalized to a 0–1 scale. Delta radiomic values were calculated as the percent change from pre- to post-treatment, and cohort-level averages were reported as mean ± standard deviation.

Results: Multiple radiomic features demonstrated consistent and interpretable changes following histotripsy:

Uniformity increased by +83.1% ± 4.9, reflecting greater voxel homogeneity.

Mean Intensity decreased by −22.9% ± 4.2, indicating reduced average signal intensity.

Sphericity increased by +30.4% ± 4.7, suggesting more regular lesion geometry.

Coarseness decreased by −22.1% ± 3.1, pointing to smoother textures.

Contrast declined by −25.8% ± 4.4, indicating reduced internal variability.

Mesh Volume expanded by +58.6% ± 8.9, consistent with lesion cavitation.

GLCM_Energy and GLCM_Homogeneity rose by +14.2% ± 2.7 and +13.0% ± 2.5, respectively.

Kurtosis increased by +29.1% ± 3.8, while Skewness decreased by −18.0% ± 2.9, suggesting changes in intensity distribution.

Surface Area rose by +16.9% ± 3.6, likely reflecting the increased size of the ablation margins relative to the original lesion.

GLRLM_LongRunEmphasis and GLSZM_LargeZoneEmphasis increased by +50.3% ± 6.5 and +61.7% ± 7.8, respectively.

Conclusion: Radiomic analysis revealed consistent post-treatment changes across multiple features following successful liver histotripsy, including increased uniformity, sphericity, and structural homogeneity, and decreased intensity heterogeneity. These findings support delta radiomics as a promising, non-invasive method for assessing treatment response and optimizing therapeutic parameters in histotripsy. With a larger sample size, these data may be used to develop predictive models of post-histotripsy treatment response.