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Published on: February 16, 2016
Does Coronary CTA-Based Radiomics Have Incremental Value to Anatomic and Hemodynamic Analysis in Identifying Culprit
Shuo Zhang1, Xia Li2, Yan Deng3
1Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (S.Z., K.Z., H.Z., P.N.).
Rationale And Objectives:
Radiomics has great potential in identifying vulnerable plaques and predicting plaque progression. This study aims to investigate whether coronary CT angiography (CCTA)-based radiomics provides incremental value over anatomical and hemodynamic parameters for identifying culprit lesions in acute myocardial infarction (AMI).
Materials And Methods:
This multicenter study retrospectively enrolled AMI patients who underwent CCTA within 48 h of admission. Culprit lesions were adjudicated using invasive coronary angiography and electrocardiograms. CCTA-based anatomical parameters (coronary artery disease reporting and data system [CAD-RADS], high-risk plaque [HRP]), hemodynamic parameters (fractional flow reserve derived by coronary CTA [FFRCT], change in FFRCT across the lesion [ΔFFRCT]), and the radiomics features of plaques were analyzed. The ability to identify culprit lesions was compared among four non-radiomics models (CAD-RADS, CAD-RADS+HRP, optimal hemodynamic, and combined anatomic-hemodynamic) and two radiomics-containing models (radiomics-only and integrated anatomic-hemodynamic-radiomics).
Results:
Among 491 patients, 491 culprit and 1869 non-culprit lesions were analyzed. In the test cohorts 1 and 2, CAD-RADS+HRP+ΔFFRCT demonstrated the best diagnostic performance compared to other models, achieving AUCs of 0.877 (95% CI: 0.847-0.906) and 0.853 (95% CI: 0.817-0.885), respectively. CAD-RADS+HRP+ΔFFRCT significantly outperformed CAD-RADS, CAD-RADS+HRP, and Radiomics (all p<0.05). Additionally, CAD-RADS+HRP+ΔFFRCT+Radiomics did not outperform CAD-RADS+HRP+ΔFFRCT (p>0.05).
Conclusion:
The CCTA-based anatomic-hemodynamic model accurately identifies culprit lesions in patients with AMI, while radiomics provides no significant incremental benefit.
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