Prediction of the Statin responders with radiomics
Sang-Eun Lee1, Youngtaek Hong2, Juyeong Jung3
1Division of Cardiology, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea.
Background:
Statins are a cornerstone medication for coronary atherosclerosis. This study assessed whether radiomic analysis of coronary computed tomography angiography (CCTA) could predict patient response to statin therapy.
Methods:
Patients from a multinational registry with serial CCTA (≥2-year intervals) on statin therapy were analyzed. Radiomic scores were calculated, categorizing patients as statin responders or non-responders (≥1.0% increase in percent atheroma volume (PAV) per year indicated non-response). Data were split into training (79%) and test (21%) sets based on sites. Four predictive models were developed: Model 1 used clinical risk factors (CRF), Model 2 included CRF, calcified and non-calcified PAV, and number of high-risk plaques. Model 3 used only the radiomic score, and Model 4 combined Models 2 and 3.
Results:
A total of 386 statin responders (mean age 61.2 ± 8.4 years, 60.1% male) and 177 statin non-responders (mean age 63.2 ± 9.0 years, 44.1% male) were analyzed. Model 3, based solely on the radiomic score, demonstrated superior predictive power compared to Model 1 (area under the receiver operating characteristic curve [AUC] [95% confidence interval (CI)]: 0.75 [0.67-0.83] vs 0.54 [0.45-0.63], p < 0.05) and was comparable to Model 2 (AUC [95% CI]: 0.82 [0.74-0.88], p > 0.05) in the test set. Model 4 exhibited the highest power (AUC [95% CI]: 0.84 [0.77-0.90], all p < 0.05 compared to Model 2 and Model 3).
Conclusion:
CCTA radiomic features show proof-of-concept for predicting statin response, warranting further validation.
Clinical Trial Registration:
ClinicalTrials.gov NCT0280341.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...