ObjectiveTo investigate the classification ability of quantitative radiomics features extracted on non-contrast-enhanced CT (NECT) image for discrimination of AVM-related hematomas from those caused by other etiologies.MethodsTwo hundred sixty-one cases with intraparenchymal hematomas underwent baseline CT scan between 2012 and 2017 in our center. Cases were split into a training dataset (n=180) and a test dataset (n=81). Hematoma types were dichotomized into two classes, namely, AVM-related hematomas (AVM-H) and hematomas caused by other etiologies. A total of 576 radiomics features of 6 feature groups were extracted from NECT. We applied 11 feature selection methods to select informative features from each feature group. Selected radiomics features and the clinical feature age were then used to fit machine learning classifiers. In combination of the 11 feature selection methods and 8 classifiers, we constructed 88 predictive models. Predictive models were evaluated and the optimal one was selected and evaluated.ResultsThe selected radiomics model was RELF_Ada, which was trained with Adaboost classifier and features selected by Relief method. Cross-validated area under the curve (AUC) on training dataset was 0.988 and the relative standard deviation (RSD%) was 0.062. AUC on the test dataset was 0.957. Accuracy (ACC), sensitivity, specificity, positive prediction value (PPV), and negative predictive value (NPV) were 0.926, 0.889, 0.937, 0.800, and 0.967, respectively.ConclusionsMachine learning models with radiomics features extracted from NECT scan accurately discriminated AVM-related intraparenchymal hematomas from those caused by other etiologies. This technique provided a fast, non-invasive approach without use of contrast to diagnose this disease.Key Points center dot Radiomics features from non-contrast-enhanced CT accurately discriminated AVM-related hematomas from those caused by other etiologies.center dot AVM-related hematomas tended to be larger in diameter, coarser in texture, and more heterogeneous in composition.center dot Adaboost classifier is an efficient approach for analyzing radiomics features.