Deep Learning-Derived Cardiac Chamber Volumes and Mass From PET/CT Attenuation Scans: Associations With Myocardial Flow Reserve and Heart Failure.

IF 6.5 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Circulation: Cardiovascular Imaging Pub Date : 2025-05-13 DOI:10.1161/CIRCIMAGING.124.018188

Waseem Hijazi, Aakash Shanbhag, Robert J H Miller, Paul B Kavanagh, Aditya Killekar, Mark Lemley, Samuel Wopperer, Stacey Knight, Viet T Le, Steve Mason, Wanda Acampa, Tom Rosamond, Damini Dey, Daniel S Berman, Panithaya Chareonthaitawee, Marcelo F Di Carli, Piotr J Slomka

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引用次数: 0

Abstract

Background: Computed tomography (CT) attenuation correction scans are an intrinsic part of positron emission tomography (PET) myocardial perfusion imaging using PET/CT, but anatomic information is rarely derived from these ultralow-dose CT scans. We aimed to assess the association between deep learning-derived cardiac chamber volumes (right atrial, right ventricular, left ventricular, and left atrial) and mass (left ventricular) from these scans with myocardial flow reserve and heart failure hospitalization.

Methods: We included 18 079 patients with consecutive cardiac PET/CT from 6 sites. A deep learning model estimated cardiac chamber volumes and left ventricular mass from computed tomography attenuation correction imaging. Associations between deep learning-derived CT mass and volumes with heart failure hospitalization and reduced myocardial flow reserve were assessed in a multivariable analysis.

Results: During a median follow-up of 4.3 years, 1721 (9.5%) patients experienced heart failure hospitalization. Patients with 3 or 4 abnormal chamber volumes were 7× more likely to be hospitalized for heart failure compared with patients with normal volumes. In adjusted analyses, left atrial volume (hazard ratio [HR], 1.25 [95% CI, 1.19-1.30]), right atrial volume (HR, 1.29 [95% CI, 1.23-1.35]), right ventricular volume (HR, 1.25 [95% CI, 1.20-1.31]), left ventricular volume (HR, 1.27 [95% CI, 1.23-1.35]), and left ventricular mass (HR, 1.25 [95% CI, 1.18-1.32]) were independently associated with heart failure hospitalization. In multivariable analyses, left atrial volume (odds ratio, 1.14 [95% CI, 1.0-1.19]) and ventricular mass (odds ratio, 1.12 [95% CI, 1.6-1.17]) were independent predictors of reduced myocardial flow reserve.

Conclusions: Deep learning-derived chamber volumes and left ventricular mass from computed tomography attenuation correction were predictive of heart failure hospitalization and reduced myocardial flow reserve in patients undergoing cardiac PET perfusion imaging. This anatomic data can be routinely reported along with other PET/CT parameters to improve risk prediction.

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PET/CT衰减扫描的深度学习衍生心室体积和质量：与心肌血流储备和心力衰竭的关系。

背景：计算机断层扫描（CT）衰减校正扫描是使用PET/CT的正电子发射断层扫描（PET）心肌灌注成像的固有组成部分，但很少从这些超低剂量CT扫描中获得解剖信息。我们的目的是评估深度学习衍生的心室容积（右心房、右心室、左心室和左心房）和质量（左心室）与心肌血流储备和心力衰竭住院治疗之间的关系。方法：我们纳入了18 079例来自6个部位的连续心脏PET/CT。深度学习模型通过计算机断层衰减校正成像估计心腔体积和左心室质量。在多变量分析中评估了深度学习衍生的CT质量和体积与心力衰竭住院和心肌血流储备减少之间的关系。结果：在中位随访4.3年期间，1721例（9.5%）患者因心力衰竭住院。与容量正常的患者相比，3或4个心室容量异常的患者因心力衰竭住院的可能性要高7倍。在校正分析中，左心房容积（风险比[HR]， 1.25 [95% CI, 1.19-1.30]）、右心房容积（HR, 1.29 [95% CI, 1.23-1.35]）、右心室容积（HR, 1.25 [95% CI, 1.20-1.31]）、左心室容积（HR, 1.27 [95% CI, 1.23-1.35]）和左心室质量（HR, 1.25 [95% CI, 1.18-1.32]）与心力衰竭住院独立相关。在多变量分析中，左房容积（优势比，1.14 [95% CI, 1.0-1.19]）和心室质量（优势比，1.12 [95% CI, 1.6-1.17]）是心肌血流储备减少的独立预测因子。结论：在接受心脏PET灌注成像的患者中，通过计算机断层衰减校正得到的深度学习衍生的心室容积和左心室质量可预测心力衰竭住院和心肌血流储备减少。该解剖数据可与其他PET/CT参数一起常规报告，以提高风险预测。

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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来源期刊

Circulation: Cardiovascular Imaging 医学-核医学

CiteScore

6.30

自引率

2.70%

发文量

225

审稿时长

6-12 weeks

期刊介绍： Circulation: Cardiovascular Imaging, an American Heart Association journal, publishes high-quality, patient-centric articles focusing on observational studies, clinical trials, and advances in applied (translational) research. The journal features innovative, multimodality approaches to the diagnosis and risk stratification of cardiovascular disease. Modalities covered include echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging and spectroscopy, magnetic resonance angiography, cardiac positron emission tomography, noninvasive assessment of vascular and endothelial function, radionuclide imaging, molecular imaging, and others. Article types considered by Circulation: Cardiovascular Imaging include Original Research, Research Letters, Advances in Cardiovascular Imaging, Clinical Implications of Molecular Imaging Research, How to Use Imaging, Translating Novel Imaging Technologies into Clinical Applications, and Cardiovascular Images.