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Cardiovascular magnetic resonance radiologic-pathologic correlation in radiomic analysis of myocardium in
Amine Amyar1, Shiro Nakamori2, Long Ngo1
1Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
Insights
Cardiovascular magnetic resonance (CMR) radiomics show associations with myocardial tissue composition in dilated cardiomyopathy (DCM) patients. These imaging biomarkers correlate with histological findings from invasive biopsies.
Area of Science:
- Cardiovascular Imaging
- Radiomics
- Cardiac Pathology
Background:
- Growing interest in cardiovascular magnetic resonance (CMR) radiomic signatures as novel imaging biomarkers for cardiac disease.
- Limited understanding of the pathological correlates of myocardial radiomics on CMR.
- Need to investigate associations between CMR radiomic signatures and histological features in non-ischemic dilated cardiomyopathy (DCM).
Purpose of the Study:
- To investigate the association between CMR myocardial radiomic signatures and histological features in patients with DCM.
- To explore the relationship between radiomic features from native T1, extracellular volume (ECV), and late gadolinium enhancement (LGE) sequences and myocardial tissue composition.
Main Methods:
- Analysis of CMR images from 132 DCM patients who underwent CMR followed by endomyocardial biopsy.
- Computation of radiomic first-order and textural features from mid-septal myocardium near the biopsy region for native T1, ECV, and LGE sequences.
- Application of hierarchical clustering to identify radiomic clusters and logistic regression to evaluate associations between cluster medoids and histological features.
Main Results:
- Two radiomic clusters were identified for each CMR sequence.
- Native T1 radiomic signatures were associated with fibrosis, inflammation, myocyte hypertrophy, vacuolization, and fat replacement.
- ECV and LGE radiomic signatures showed associations with fibrosis, myocyte hypertrophy, and vacuolization.
Conclusions:
- CMR radiomic signatures are significantly associated with myocardial tissue composition in DCM patients.
- Radiomics derived from native T1, ECV, and LGE sequences provide insights into underlying myocardial pathology.
- These findings support the potential of CMR radiomics as non-invasive biomarkers for assessing cardiac tissue characteristics.
Background:
There is a growing interest in cardiovascular magnetic resonance (CMR) radiomic signatures as novel imaging biomarkers of cardiac disease. However, very little is known about pathological correlates of the radiomics signature of myocardium on CMR sequences. In this study, we sought to investigate the association between CMR myocardial radiomic signatures and histological features in patients with non-ischemic dilated cardiomyopathy (DCM).
Methods:
CMR images from DCM patients who underwent CMR followed by endomyocardial biopsy within 6 [2-15] days were used to investigate the association between myocardial radiomic signatures measured from native T1, extra-cellular volume (ECV), late gadolinium enhancement (LGE) and histological features. Radiomic first-order and textural features were computed for each sequence from the mid-septal myocardium near the biopsy region. Hierarchical clustering was then applied to identify distinct radiomic clusters. A representative feature known as the "medoid" was identified within each cluster based on its minimal dissimilarity from other features. Logistic regression models were built using one medoid per model to evaluate the association between each medoid and histological feature. Association was determined using odds ratio (OR) with a 95% confidence interval.
Results:
132 DCM patients (71% male, 94/132; 54 ± 15 years) were included in the study. Clustering analysis unveiled two radiomic clusters for each sequence. For native T1, the medoids were textural features. The first medoid was associated with fibrosis, inflammation, myocyte hypertrophy, vacuolization, and fat replacement (OR = 2.84 [1.62-5.46]; OR = 2.05 [1.15-4.03]; OR = 2.39 [1.01-6.62]; OR = 2.03 [1.22-3.60]; OR = 0.35 [0.12-0.86]; respectively). The second medoid was associated with nuclear generation (OR = 0.55 [0.31-0.91]). ECV medoids included first-order and textural features. The first-order medoid was associated with fibrosis (OR = 2.97 [1.75-5.46]), myocyte hypertrophy (OR = 3.20 [1.17-10.37]), and nuclear degeneration (OR = 1.66 [1.02-2.89]), while medoid 2 (texture) was associated with fibrosis (OR = 4.44 [2.26-10.00]). LGE medoid 1 (texture) was associated with myocyte hypertrophy (OR = 0.31 [0.10-0.77]), while medoid 2 (texture) was associated with fibrosis (OR = 2.40 [1.38-4.66]) and vacuolization (OR = 2.00 [1.16-3.72]).
Conclusions:
In DCM patients, CMR radiomic signatures were associated with myocardial tissue composition, as assessed by invasive biopsy.
