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Development and validation of a radiomics model for detecting cardiac amyloidosis at coronary computed tomography
Qingchao Meng1, Li Zhao1, Xiaoxin Sun2
1Department of Radiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/National Center for Cardiovascular Diseases, #167 Bei-Li-Shi Street, Beijing 100037, China.
Insights
Computed tomography (CT)-based radiomics effectively detects cardiac amyloidosis (CA) in patients with diffuse myocardial thickening. This radiomics model significantly outperformed standard CT attenuation measurements for CA diagnosis.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Cardiac amyloidosis (CA) is a significant cause of heart failure.
- Diffuse myocardial thickening is a common presentation of CA.
- Accurate and early diagnosis of CA is crucial for patient management.
Purpose of the Study:
- To evaluate the diagnostic performance of computed tomography (CT)-based radiomics for detecting cardiac amyloidosis (CA).
- To compare the efficacy of a radiomics model against standard myocardial CT attenuation measurements in patients with diffuse myocardial thickening.
Main Methods:
- Retrospective enrollment of 378 patients with diffuse myocardial thickening from five hospitals.
- Development of a radiomics model using features extracted from myocardial regions of interest.
- Comparison of the radiomics model's diagnostic performance with myocardial CT attenuation using area under the curve and decision curve analysis.
Main Results:
- The radiomics model demonstrated significantly higher diagnostic accuracy than myocardial CT attenuation across training, internal, and external test cohorts (AUCs 0.95, 0.95, and 0.91 vs. 0.58, 0.59, and 0.64, respectively).
- Decision curve analysis confirmed the superior clinical utility of the radiomics model.
- Radiomics scores showed significant correlations with N-terminal proB-type natriuretic peptide and left ventricular diastolic diameter.
Conclusions:
- A CT-based radiomics model shows excellent diagnostic performance for cardiac amyloidosis in patients with hypertrophic phenotypes.
- The radiomics approach significantly outperforms traditional myocardial CT attenuation measurements for CA detection.
Aims:
To investigate the diagnostic performance of computed tomography (CT)-based radiomics in detecting cardiac amyloidosis (CA) in patients with diffuse myocardial thickening.
Methods And Results:
Patients with diffuse myocardial thickening who underwent coronary CT angiography were retrospectively enrolled from five hospitals. Patients from one hospital were randomly divided into training and internal test cohorts at a 7:3 ratio, and the other four hospitals constituted the external test cohort. The diagnosis of CA followed established guidelines. Regions of interest of myocardium were delineated to extract radiomics features to construct the radiomics model, and myocardial CT attenuation was measured. The diagnostic performance and clinical utility of the radiomics model and myocardial CT attenuation were compared with the area under the curve and decision curve analysis. The correlation between radiomics score and left ventricular function was analysed. A total of 378 patients (median age, 57 years; 257 men) were enrolled. Ten features were selected to construct the radiomics model. The areas under the curve of radiomics model were significantly higher than myocardial CT attenuation in the training (0.95 vs. 0.58, P < 0.001), internal test (0.95 vs. 0.59, P < 0.001), and external test cohorts (0.91 vs. 0.64, P < 0.001). Decision curve analysis indicated the radiomics model provided a greater net benefit than myocardial CT attenuation across cohorts. Radiomics scores were correlated with N-terminal proB-type natriuretic peptide and left ventricular diastolic diameter across cohorts (P < 0.05).
Conclusion:
The radiomics model exhibited good diagnostic performance for CA detection in patients with hypertrophic phenotypes, outperforming myocardial CT attenuation.
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