Radiomics-Based Precision Phenotyping Identifies Unstable Coronary Plaques From Computed Tomography Angiography

Lin A, Kolossváry M, Cadet S, McElhinney P, Göller M, Han D, Yuvaraj J, Nerlekar N, Slomka PJ, Marwan M, Nicholls SJ, Achenbach S, Maurovich-Horvat P, Wong DT, Dey D (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Journal of the American College of Cardiology : Cardiovascular imaging Elsevier

Book Volume: 15

Pages Range: 859-871

Journal Issue: 5

DOI: 10.1016/j.jcmg.2021.11.016

Abstract

Objectives: The aim of this study was to precisely phenotype culprit and nonculprit lesions in myocardial infarction (MI) and lesions in stable coronary artery disease (CAD) using coronary computed tomography angiography (CTA)-based radiomic analysis. Background: It remains debated whether any single coronary atherosclerotic plaque within the vulnerable patient exhibits unique morphology conferring an increased risk of clinical events. Methods: A total of 60 patients with acute MI prospectively underwent coronary CTA before invasive angiography and were matched to 60 patients with stable CAD. For all coronary lesions, high-risk plaque (HRP) characteristics were qualitatively assessed, followed by semiautomated plaque quantification and extraction of 1,103 radiomic features. Machine learning models were built to examine the additive value of radiomic features for discriminating culprit lesions over and above HRP and plaque volumes. Results: Culprit lesions had higher mean volumes of noncalcified plaque (NCP) and low-density noncalcified plaque (LDNCP) compared with the highest-grade stenosis nonculprits and highest-grade stenosis stable CAD lesions (NCP: 138.1 mm3 vs 110.7 mm3 vs 102.7 mm3; LDNCP: 14.2 mm3 vs 9.8 mm3 vs 8.4 mm3; both Ptrend < 0.01). In multivariable linear regression adjusted for NCP and LDNCP volumes, 14.9% (164 of 1,103) of radiomic features were associated with culprits and 9.7% (107 of 1,103) were associated with the highest-grade stenosis nonculprits (critical P < 0.0007) when compared with highest-grade stenosis stable CAD lesions as reference. Hierarchical clustering of significant radiomic features identified 9 unique data clusters (latent phenotypes): 5 contained radiomic features specific to culprits, 1 contained features specific to highest-grade stenosis nonculprits, and 3 contained features associated with either lesion type. Radiomic features provided incremental value for discriminating culprit lesions when added to a machine learning model containing HRP and plaque volumes (area under the receiver-operating characteristic curve 0.86 vs 0.76; P = 0.004). Conclusions: Culprit lesions and highest-grade stenosis nonculprit lesions in MI have distinct radiomic signatures compared with lesions in stable CAD. Within the vulnerable patient may exist individual vulnerable plaques identifiable by coronary CTA-based precision phenotyping.

Authors with CRIS profile

Markus Göller Department of Medicine 2 – Cardiology and Angiology Mohamed Marwan Medizinische Fakultät Stephan Achenbach Lehrstuhl für Innere Medizin II

Involved external institutions

Cedars-Sinai Medical Center US United States (USA) (US) Veterans Affairs Healthcare System Boston and Harvard Medical School US United States (USA) (US) Monash University AU Australia (AU) Semmelweis University / Semmelweis Egyetem HU Hungary (HU)

How to cite

APA:

Lin, A., Kolossváry, M., Cadet, S., McElhinney, P., Göller, M., Han, D.,... Dey, D. (2022). Radiomics-Based Precision Phenotyping Identifies Unstable Coronary Plaques From Computed Tomography Angiography. Journal of the American College of Cardiology : Cardiovascular imaging, 15(5), 859-871. https://dx.doi.org/10.1016/j.jcmg.2021.11.016

MLA:

Lin, Andrew, et al. "Radiomics-Based Precision Phenotyping Identifies Unstable Coronary Plaques From Computed Tomography Angiography." Journal of the American College of Cardiology : Cardiovascular imaging 15.5 (2022): 859-871.

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