## 5 Conclusions  
We performed the first preliminary study to develop prediction models for aneurysm rupture risks using radiomics analysis based on follow-up MRA images. We found significant radiomic features which were associated with the prediction of aneurysm rupture. The AUC, accuracy, sensitivity, and specificity of the prediction model were 0.971, 0.948, 0.700, and 0.953, respectively. By overcoming the limitations mentioned above, we can develop a more robust radiomics analysis system with higher AUC, accuracy, sensitivity, and specificity. This radiomics analysis system could be utilized to predict aneurysm rupture risks for SAH prevention during follow-up MRA examinations.  
**Supplementary Materials:** The following supporting information can be downloaded at: [[https://www.mdpi.com/article/10.3390/app12178615/s1](https://www.mdpi.com/article/10.3390/app12178615/s1)]([https://www.mdpi.com/article/10.3390/app12178615/s1](https://www.mdpi.com/article/10.3390/app12178615/s1)). Table S1. Radionic features used in the calculation. Table S2. AUCs, sensitivity, specificity, and accuracy of a proposed rupture prediction model from training and test images with top combinations of LASSO ranking.  
**Author Contributions:** Conceptualization: M.Y. and H.A.; methodology: M.Y. and H.A.; software: M.Y., T.K., and A.U.; formal analysis: M.Y. and H.A.; writing--original draft preparation: M.Y. and H.A.; writing--review and editing: M.Y., H.A., and T.K. All authors have read and agreed to the published version of the manuscript.  
**Funding:** This study was supported by a JSPS KAKENHI grant (Number JP20K08084).  
**Institutional Review Board Statement:** This retrospective study was performed with an ethical approval from the Institutional Review Board (IRB) of Kokura Memorial Hospital. According to the IRB, informed consents were waived due to the retrospective nature, and all patients' data were used anonymously. All procedures in the studies involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not involve any animal study performed by the authors.  
**Informed Consent Statement:** According to the IRB, informed consents were waived due to the retrospective nature.  
**Data Availability Statement:** The data that support the findings of this study are available from the corresponding author upon reasonable request.  
**Acknowledgments:** The authors are grateful to [PERSON], who is a neurosurgeon in Kokura Memorial Hospital (current affiliation: Hikone Municipal Hospital) for selecting ruptured and unruptured aneurysm cases and determining aneurysm regions. The authors would like to say many thanks to all the members of the Arimura Laboratory ([[http://web.shs.kyushu-u.ac.jp/~arimura/](http://web.shs.kyushu-u.ac.jp/~arimura/)]([http://web.shs.kyushu-u.ac.jp/~arimura/](http://web.shs.kyushu-u.ac.jp/~arimura/)) (accessed on 27 August 2022)), whose comments contributed to this study.  
**Conflicts of Interest:** The authors declare no conflict of interest.