Machine learning-based radiomic features of perivascular adipose tissue in coronary computed tomography angiography predicting inflammation status around atherosclerotic plaque: a retrospective cohort study.

Annals of medicine Pub Date : 2025-12-01 Epub Date: 2024-12-12 DOI:10.1080/07853890.2024.2431606
Kunlin Ye, Lingtao Zhang, Hao Zhou, Xukai Mo, Changzheng Shi
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Abstract

Objectives: This study expolored the relationship between perivascular adipose tissue (PVAT) radiomic features derived from coronary computed tomography angiography (CCTA) and the presence of coronary artery plaques. It aimed to determine whether PVAT radiomic could non-invasively assess vascular inflammation associated with plaque presence.

Methods: In this retrospective cohort study, data from patients undergoing coronary artery examination between May 2021 and December 2022 were analyzed. Demographics, clinical data, plaque location and stenosis severity were recorded. PVAT radiomic features were extracted using PyRadiomics with key features selected using Least Absolute Shrinkage and Selection Operator (LASSO) and recursive feature elimination (RFE) to create a radiomics signature (RadScore).Stepwise logistic regression identified clinical predictors. Predictive models (clinical, radiomics-based and combined) were constructed to differentiate plaque-containing segments from normal ones. The final model was presented as a nomogram and evaluated using calibration curves, ROC analysis and decision curve analysis.

Results: Analysis included 208 coronary segments from 102 patients. The RadScore achieved an Area Under the Curve (AUC) of 0.897 (95% CI: 0.88-0.92) in the training set and 0.717 (95% CI: 0.63-0.81) in the validation set. The combined model (RadScore + Clinic) demonstrated improved performance with an AUC of 0.783 (95% CI: 0.69-0.87) in the validation set and 0.903 (95% CI: 0.83-0.98) in an independent test set. Both RadScore and combined models significantly outperformed the clinical model (p < .001). The nomogram integrating clinical and radiomics features showed robust calibration and discrimination (c-index: 0.825 in training, 0.907 in testing).

Conclusion: CCTA-based PVAT radiomics effectively distinguished coronary artery segments with and without plaques. The combined model and nomogram demostrated clinical utility, offering a novel approach for early diagnosis and risk stratification in coronary heart disease.

冠状动脉ct血管造影中基于机器学习的血管周围脂肪组织放射学特征预测动脉粥样硬化斑块周围的炎症状态:一项回顾性队列研究。
目的:本研究探讨冠状动脉ct血管造影(CCTA)显示的血管周围脂肪组织(PVAT)放射学特征与冠状动脉斑块之间的关系。目的是确定PVAT放射组学是否可以无创评估与斑块存在相关的血管炎症。方法:在这项回顾性队列研究中,分析了2021年5月至2022年12月接受冠状动脉检查的患者的数据。记录人口统计学、临床资料、斑块位置和狭窄严重程度。使用PyRadiomics提取PVAT放射组学特征,使用最小绝对收缩和选择算子(LASSO)和递归特征消除(RFE)选择关键特征,以创建放射组学签名(RadScore)。逐步逻辑回归确定了临床预测因素。构建了预测模型(临床模型、放射组学模型和综合模型)来区分含斑块的节段和正常的节段。最终模型以nomogram表示,并使用校正曲线、ROC分析和决策曲线分析进行评估。结果:分析了102例患者的208个冠状动脉段。RadScore在训练集中的曲线下面积(AUC)为0.897 (95% CI: 0.88-0.92),在验证集中为0.717 (95% CI: 0.63-0.81)。联合模型(RadScore + Clinic)在验证集中的AUC为0.783 (95% CI: 0.69-0.87),在独立测试集中的AUC为0.903 (95% CI: 0.83-0.98),显示出更好的性能。结论:基于ccta的PVAT放射组学可以有效区分有斑块和没有斑块的冠状动脉段。该模型与nomogram相结合,为冠心病的早期诊断和风险分层提供了一种新的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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