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Published on: June 23, 2015
Incremental Prognostic Value of Pericardial Adipose Tissue Radiomic Phenotype Based on Cardiac MRI in Patients With
Tian-Yi Zhang1, Youqi Liu1, Shuai-Zheng Chen2
1Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Background:
While pericardial adipose tissue (PEAT) volume is linked to cardiac risk, the prognostic value of its radiomic features for major adverse cardiac events (MACE: a composite of cardiac death, myocardial infarction, heart failure hospitalization, or stroke) in end-stage renal disease (ESRD) patients is unknown.
Purpose:
To evaluate the association of PEAT radiomics with MACE in patients with ESRD.
Study Type:
Retrospective.
Population:
Two hundred forty-eight ESRD patients (160 males) from three centers were included and divided into development (198 patients) and validation cohorts (50 patients) by centers.
Field Strength/Sequence:
3.0 T/cine imaging, T2 and T2* mappings, all gradient echo.
Assessment:
A triple-stage Unet model (3SUnet) was used for the segmentation of PEAT in cine images. Myocardial T2 and T2* values were extracted from native T2 and T2* images. Demographic and laboratory data were collected within 1 week of the MRI scan. Participants were followed up from the MRI scanning every 2 weeks until July 2023 until MACE occurred.
Statistical Tests:
Principal component analysis (PCA) was used to reduce radiomic features to principal radiomics (PrPEAT-rads). Cox regression analyses were used to investigate the prognostic value of extracted PrPEAT-rads. p-value ≤ 0.05 was considered statistically significant.
Results:
During a median follow-up time of 35.6 months, 63 patients (25.4% of 248; 15 in the external validation cohort) experienced MACE. The combined use of selected PrPEAT-rads with conventional MRI risk scores significantly improved risk stratification of MACE in both the internal (C-index: 0.715 vs. 0.768; integrated Brier score [IBS]: 0.095 vs. 0.090) and the external validation cohort (C-index: 0.737 vs. 0.774; IBS: 0.130 vs. 0.070). PrPEAT-rad1 was a significant independent factor associated with MACE after adjusting for both clinical (HR: 0.937) and MRI (HR: 0.916) covariates.
Data Conclusion:
The cardiac MRI cine-based PEAT radiomics features in ESRD patients demonstrated a stronger association with MACE compared to conventional clinical and MRI parameters.
Evidence Level:
3.
Stage Of Technology Efficacy:
Stage 2.
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