A CCTA-based radiomics score of pericoronary adipose tissue significantly outperformed a conventional plaque score in predicting future acute coronary syndrome within 3 years (AUC 0.826 vs 0.699).
Case-Control (n=1,586)
Single-blind
No
Does a CCTA-based radiomics signature of pericoronary adipose tissue improve the prediction of future acute coronary syndrome within 3 years in patients with suspected CAD?
A CCTA-based radiomics signature of pericoronary adipose tissue significantly outperformed conventional plaque scores in predicting the occurrence of acute coronary syndrome within 3 years.
Effect estimate: AUC 0.826 (95% CI 0.758-0.895)
p-value: p=0.009
OBJECTIVES: To evaluate whether radiomics signature of pericoronary adipose tissue (PCAT) based on coronary computed tomography angiography (CCTA) could improve the prediction of future acute coronary syndrome (ACS) within 3 years. METHODS: We designed a retrospective case-control study that patients with ACS (n = 90) were well matched to patients with no cardiac events (n = 1496) during 3 years follow-up, then which were randomly divided into training and test datasets with a ratio of 3:1. A total of 107 radiomics features were extracted from PCAT surrounding lesions and 14 conventional plaque characteristics were analyzed. Radiomics score, plaque score, and integrated score were respectively calculated via a linear combination of the selected features, and their performance was evaluated with discrimination, calibration, and clinical application. RESULTS: Radiomics score achieved superior performance in identifying patients with future ACS within 3 years in both training and test datasets (AUC = 0.826, 0.811) compared with plaque score (AUC = 0.699, 0.640), with a significant difference of AUC between two scores in the training dataset (p = 0.009); while the improvement of integrated score discriminating capability (AUC = 0.838, 0.826) was non-significant. The calibration curves of three predictive models demonstrated a good fitness respectively (all p > 0.05). Decision curve analysis suggested that integrated score added more clinical benefit than plaque score. Stratified analysis revealed that the performance of three predictive models was not affected by tube voltage, CT version, different sites of hospital. CONCLUSION: CCTA-based radiomics signature of PCAT could have the potential to predict the occurrence of subsequent ACS. Radiomics-based integrated score significantly outperformed plaque score in identifying future ACS within 3 years. KEY POINTS: • Plaque score based on conventional plaque characteristics had certain limitations in the prediction of ACS. • Radiomics signature of PCAT surrounding plaques could have the potential to improve the predictive ability of subsequent ACS. • Radiomics-based integrated score significantly outperformed plaque score in the identification of future ACS within 3 years.
Shang et al. (Wed,) conducted a case-control in Suspected coronary artery disease (n=1,586). Radiomics score of pericoronary adipose tissue vs. Conventional plaque score was evaluated on Prediction of future acute coronary syndrome within 3 years (Training dataset) (AUC 0.826, 95% CI 0.758-0.895, p=0.009). A CCTA-based radiomics score of pericoronary adipose tissue significantly outperformed a conventional plaque score in predicting future acute coronary syndrome within 3 years (AUC 0.826 vs 0.699).