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A radiomic nomogram for prediction of major adverse cardiac events in ST-segment elevation myocardial infarction
Quanmei Ma1, Yue Ma1, Xiaonan Wang1
1Department of Radiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, Liaoning, China.
Insights
A new radiomic nomogram using non-contrast T1 mapping accurately predicts major adverse cardiac events (MACEs) in ST-segment elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention (PCI). This tool aids in optimizing risk stratification for individual patients.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Acute ST-segment elevation myocardial infarction (STEMI) is a critical condition requiring timely intervention.
- Percutaneous coronary intervention (PCI) is a standard treatment for STEMI.
- Accurate prediction of major adverse cardiac events (MACEs) is crucial for patient management and risk stratification.
Purpose of the Study:
- To develop and validate a radiomic nomogram based on non-contrast T1 mapping for predicting MACEs in STEMI patients undergoing PCI.
- To assess the performance of the radiomic nomogram in terms of discrimination, calibration, and clinical usefulness.
Main Methods:
- Retrospective analysis of 157 STEMI patients undergoing PCI.
- Extraction of radiomic features from non-contrast T1 mapping images using open-source software.
- Construction of a radiomic signature using the least absolute shrinkage and selection operator (LASSO) method.
- Validation of the radiomic nomogram in training and test sets.
Main Results:
- The radiomic signature demonstrated strong prognostic ability with an AUC of 0.94 in the training set and 0.90 in the test set.
- The final nomogram, incorporating radiomic scores and cardiac troponin I, showed excellent discrimination with AUCs of 0.96 and 0.94 in the training and test sets, respectively.
- The nomogram achieved an F1 score of 0.71 in the training set and 0.70 in the test set.
Conclusions:
- The non-contrast T1 map-based radiomic nomogram is a valuable tool for predicting MACEs in STEMI patients post-PCI.
- This nomogram can assist clinicians in optimizing risk stratification for individual patients.
- T1 mapping-derived radiomics offers improved MACE prediction compared to conventional cardiac MRI parameters in STEMI.
Objectives:
This study was conducted to establish and validate a non-contrast T1 map-based radiomic nomogram for predicting major adverse cardiac events (MACEs) in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI).
Methods:
This retrospective study included 157 consecutive patients (training sets, 109 patients; test sets, 48 patients) with acute STEMI undergoing PCI. An open-source radiomics software was used to segment the myocardium on the non-contrast T1 mapping and extract features. A radiomic signature was constructed to predict MACEs using the least absolute shrinkage and selection operator method. The performance of the radiomic nomogram for predicting MACEs in both the training and test sets was evaluated by its discrimination, calibration, and clinical usefulness.
Results:
The radiomic signature showed a good prognostic ability in the training sets with an AUC of 0.94 (95% CI, 0.86 to 1.00) and F1 score of 0.71, which was confirmed in the test sets with an AUC of 0.90 (95% CI, 0.74 to 1.00) and F1 score of 0.62. The nomogram consisting of the radiomic scores and cardiac troponin I showed good discrimination ability in the training and test sets with AUCs of 0.96 (95% CI, 0.91 to 1.00; F1 score, 0.71) and 0.94 (95% CI, 0.83 to 1.00; F1 score, 0.70), respectively.
Conclusions:
The non-contrast T1 map-based radiomic nomogram is a useful tool for the prediction of MACEs in patients with acute STEMI undergoing PCI that can assist clinicians for optimised risk stratification of individual patients.
Key Points:
• Radiomic signature improved MACE prediction in acute STEMI patients. • T1 mapping-derived radiomic signature outperformed conventional cardiac MRI parameters in predicting MACEs in acute STEMI patients. • The non-contrast T1 mapping-based radiomic nomogram can be used for prediction of MACEs and improvement of risk stratification in acute STEMI.
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