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Cardiovascular Magnetic Resonance Radiomics to Identify Components of the Extracellular Matrix in Dilated
Shiro Nakamori1,2, Amine Amyar1, Ahmed S Fahmy1
1Departments of Medicine (S. Nakamori, A.A., A.S.F., L.H.N., W.J.M., R.N.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
Circulation
|May 29, 2024
Summary
Cardiovascular magnetic resonance radiomics can distinguish noncollagenous expansion from collagen in dilated cardiomyopathy. This approach aids in detecting subtle inflammation, improving diagnostic accuracy for myocardial extracellular space characterization.
Area of Science:
- Cardiovascular Imaging
- Radiomics
- Biomarkers
Background:
- Current cardiovascular magnetic resonance (CMR) sequences struggle to differentiate myocardial extracellular space (ECS) components like collagen, noncollagen, and inflammation.
- Dilated cardiomyopathy (DCM) presents complex ECS changes that impact cardiac function and prognosis.
Purpose of the Study:
- To investigate if CMR radiomics analysis can differentiate noncollagenous ECS expansion from collagenous ECS expansion in patients with DCM.
- To assess the potential of radiomics in identifying myocardial inflammation associated with specific ECS phenotypes.
Main Methods:
- 132 DCM patients underwent 3T CMR with native T1 mapping, postcontrast T1 mapping, and late gadolinium enhancement (LGE).
- Radiomic features were extracted from midseptal myocardium on T1, extracellular volume (ECV), and LGE images.
- Principal component analysis (PCA) reduced features; correlation analysis identified key radiomic signatures. Histopathological biopsy data quantified ECS, fibrosis, and inflammation.
Main Results:
- Four histopathological phenotypes were identified: low collagen, noncollagenous expansion, mild-to-moderate collagenous expansion, and severe collagenous expansion.
- Noncollagenous expansion showed the highest association with myocardial inflammation (65%).
- While native T1 and ECV showed high performance for severe fibrosis, radiomics integration (ECV, native T1, LGE) significantly improved discrimination between noncollagenous and mild-to-moderate collagenous expansion (C-statistics 0.79, 0.75, 0.74 respectively).
Conclusions:
- CMR radiomics features from native T1, ECV, and LGE provide incremental value for differentiating noncollagenous from collagenous ECS.
- This radiomic approach shows promise for detecting subtle chronic inflammation in DCM patients.
- Radiomics enhances the characterization of myocardial extracellular space beyond conventional CMR sequences.
