Key result
Non-contrast T2-weighted texture analysis differentiates cardiac amyloidosis from HCM with ~79% accuracy, comparable to LGE.
Why the study?
The diagnostic value of texture analysis for detecting and differentiating myocardial tissue alterations on non-contrast T2-weighted CMR in cardiac amyloidosis and hypertrophic cardiomyopathy was unclear.
Does texture analysis of non-contrast T2-weighted CMR differentiate cardiac amyloidosis from hypertrophic cardiomyopathy?
Observational (n=317)
Single-blind
No
Does texture analysis of non-contrast T2-weighted CMR differentiate cardiac amyloidosis from hypertrophic cardiomyopathy?
Effect estimate: AUC 0.842 (95% CI 0.759-0.924)
Texture analysis of non-contrast T2-weighted CMR images can accurately differentiate cardiac amyloidosis from hypertrophic cardiomyopathy, offering a contrast-free alternative comparable to late gadolinium enhancement.
May support non-contrast differentiation in select cases; leaves open prospective validation before practice change.
Background To elucidate the value of texture analysis (TA) in detecting and differentiating myocardial tissue alterations on non-contrast T2-weighted CMR (cardiovascular magnetic resonance imaging) in patients with cardiac amyloidosis (CA) and hypertrophic cardiomyopathy (HCM). Methods In this retrospective study, 100 CA (58.5±10.7 years; 41 (41%) females) and 217 HCM (50.7±14.8 years, 101 (46.5%) females) patients who underwent CMR scans were included. Regions of interest for TA were delineated by two radiologists independently on non-contrast T2-weighted imaging (T2WI). Stepwise dimension reduction and texture feature selection based on reproducibility, machine learning algorithms, and correlation analyses were performed to select features. Both the CA and HCM groups were randomly divided into a training dataset and a testing dataset (7:3). After the TA model was established in the training set, the diagnostic performance of the model was validated in the testing set and further validated in a subgroup of patients with similar hypertrophy. Results The 7 independent texture features provided, in combination, a diagnostic accuracy of 86.0% (AUC=0.915; 95% CI: 0.879-0.951) in the training dataset and 79.2% (AUC=0.842; 95% CI: 0.759-0.924) in the testing dataset. The differential diagnostic accuracy in the similar hypertrophy subgroup was 82.2% (AUC=0.864, 95% CI: 0.805-0.922). The significance of the difference between the AUCs of the TA model and late gadolinium enhancement (LGE) was verified by Delong’s test ( p =0.996). All seven texture features showed significant differences between CA and HCM (all p <0.001). Conclusion Our study demonstrated that texture analysis based on non-contrast T2-weighted images could feasibly differentiate CA from HCM, even in patients with similar hypertrophy. The selected final texture features could achieve a comparable diagnostic capacity to LGE. Trial registration: Since this study is a retrospective observational study and no intervention had been involved, trial registration is waived.
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Huang et al. (2021) conducted an observational in Cardiac amyloidosis and hypertrophic cardiomyopathy (n=317). Texture analysis of non-contrast T2-weighted CMR vs. Late gadolinium enhancement (LGE) was evaluated on Diagnostic accuracy in the testing dataset (AUC 0.842, 95% CI 0.759-0.924). Texture analysis of non-contrast T2-weighted images differentiated cardiac amyloidosis from hypertrophic cardiomyopathy with 79.2% accuracy (AUC 0.842) in the testing dataset, comparable to LGE.
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