TY - JOUR
T1 - Identification of invasive and radionuclide imaging markers of coronary plaque vulnerability using radiomic analysis of coronary computed tomography angiography
AU - Kolossváry, Márton
AU - Park, Jonghanne
AU - Bang, Ji In
AU - Zhang, Jinlong
AU - Lee, Joo Myung
AU - Paeng, Jin Chul
AU - Merkely, Béla
AU - Narula, Jagat
AU - Kubo, Takashi
AU - Akasaka, Takashi
AU - Koo, Bon Kwon
AU - Maurovich-Horvat, Pál
N1 - Publisher Copyright:
© 2019 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Aims: Identification of invasive and radionuclide imaging markers of coronary plaque vulnerability by a single, widely available non-invasive technique may provide the opportunity to identify vulnerable plaques and vulnerable patients in broad populations. Our aim was to assess whether radiomic analysis outperforms conventional assessment of coronary computed tomography angiography (CTA) images to identify invasive and radionuclide imaging markers of plaque vulnerability. Methods and results: We prospectively included patients who underwent coronary CTA, sodium-fluoride positron emission tomography (NaF18-PET), intravascular ultrasound (IVUS), and optical coherence tomography (OCT). We assessed seven conventional plaque features and calculated 935 radiomic parameters from CTA images. In total, 44 plaques of 25 patients were analysed. The best radiomic parameters significantly outperformed the best conventional CT parameters to identify attenuated plaque by IVUS [fractal box counting dimension of high attenuation voxels vs. non-calcified plaque volume, area under the curve (AUC): 0.72, confidence interval (CI): 0.65-0.78 vs. 0.59, CI: 0.57-0.62; P < 0.001], thin-cap fibroatheroma by OCT (fractal box counting dimension of high attenuation voxels vs. presence of low attenuation voxels, AUC: 0.80, CI: 0.72-0.88 vs. 0.66, CI: 0.58-0.73; P < 0.001), and NaF18-positivity (surface of high attenuation voxels vs. presence of two high-risk features, AUC: 0.87, CI: 0.82-0.91 vs. 0.65, CI: 0.64-0.66; P < 0.001). Conclusion: Coronary CTA radiomics identified invasive and radionuclide imaging markers of plaque vulnerability with good to excellent diagnostic accuracy, significantly outperforming conventional quantitative and qualitative high-risk plaque features. Coronary CTA radiomics may provide a more accurate tool to identify vulnerable plaques compared with conventional methods. Further larger population studies are warranted.
AB - Aims: Identification of invasive and radionuclide imaging markers of coronary plaque vulnerability by a single, widely available non-invasive technique may provide the opportunity to identify vulnerable plaques and vulnerable patients in broad populations. Our aim was to assess whether radiomic analysis outperforms conventional assessment of coronary computed tomography angiography (CTA) images to identify invasive and radionuclide imaging markers of plaque vulnerability. Methods and results: We prospectively included patients who underwent coronary CTA, sodium-fluoride positron emission tomography (NaF18-PET), intravascular ultrasound (IVUS), and optical coherence tomography (OCT). We assessed seven conventional plaque features and calculated 935 radiomic parameters from CTA images. In total, 44 plaques of 25 patients were analysed. The best radiomic parameters significantly outperformed the best conventional CT parameters to identify attenuated plaque by IVUS [fractal box counting dimension of high attenuation voxels vs. non-calcified plaque volume, area under the curve (AUC): 0.72, confidence interval (CI): 0.65-0.78 vs. 0.59, CI: 0.57-0.62; P < 0.001], thin-cap fibroatheroma by OCT (fractal box counting dimension of high attenuation voxels vs. presence of low attenuation voxels, AUC: 0.80, CI: 0.72-0.88 vs. 0.66, CI: 0.58-0.73; P < 0.001), and NaF18-positivity (surface of high attenuation voxels vs. presence of two high-risk features, AUC: 0.87, CI: 0.82-0.91 vs. 0.65, CI: 0.64-0.66; P < 0.001). Conclusion: Coronary CTA radiomics identified invasive and radionuclide imaging markers of plaque vulnerability with good to excellent diagnostic accuracy, significantly outperforming conventional quantitative and qualitative high-risk plaque features. Coronary CTA radiomics may provide a more accurate tool to identify vulnerable plaques compared with conventional methods. Further larger population studies are warranted.
KW - coronary CT angiography
KW - intravascular ultrasound
KW - optical coherence tomography
KW - radiomics
KW - sodium-fluoride positron emission tomography
UR - http://www.scopus.com/inward/record.url?scp=85064646283&partnerID=8YFLogxK
U2 - 10.1093/ehjci/jez033
DO - 10.1093/ehjci/jez033
M3 - Article
C2 - 30838375
AN - SCOPUS:85064646283
SN - 2047-2404
VL - 20
SP - 1250
EP - 1258
JO - European Heart Journal Cardiovascular Imaging
JF - European Heart Journal Cardiovascular Imaging
IS - 11
ER -