Abstract
Objectives
To determine the value of combining conventional plaque parameters and radiomics features derived from coronary computed tomography angiography (CCTA) for predicting coronary plaque progression.
Materials and methods
Clinical data and CCTA images of 400 patients who underwent at least two CCTA examinations between January 2009 and August 2020 were analyzed retrospectively. Diameter stenosis, total plaque volume and burden, calcified plaque volume and burden, noncalcified plaque volume and burden (NCPB), pericoronary fat attenuation index (FAI), and other conventional plaque parameters were recorded. The patients were assigned to a training cohort (n = 280) and a validation cohort (n = 120) in a 7:3 ratio using a stratified random splitting method. The area under the receiver operating characteristics curve (AUC) was used to evaluate the predictive abilities of conventional parameters (model 1), radiomics features (model 2), and their combination (model 3).
Results
FAI and NCPB were identified as independent risk factors for coronary plaque progression in the training cohort. Both model 2 (training cohort AUC: 0.814, p < 0.001; validation cohort AUC: 0.729, p = 0.288) and model 3 (training cohort AUC: 0.824, p < 0.001; validation cohort AUC: 0.758, p = 0.042) had better diagnostic performances in predicting plaque progression than model 1 (training cohort AUC: 0.646; validation cohort AUC: 0.654). Moreover, model 3 was slightly higher than model 2, although not statistically significant.
Conclusions
The combination of conventional coronary plaque parameters and CCTA-derived radiomics features had a better ability to predict plaque progression than conventional parameters alone.
Clinical relevance statement
The conventional coronary plaque characteristics such as noncalcified plaque burden, pericoronary fat attenuation index, and radiomics features derived from CCTA can identify plaques prone to progression, which is helpful for further clinical decision-making of coronary artery disease.
Key Points
• FAI and NCPB were identified as independent risk factors for predicting plaque progression.
• Coronary plaque radiomics features were more advantageous than conventional parameters in predicting plaque progression.
• The combination of conventional coronary plaque parameters and radiomics features could significantly improve the predictive ability of plaque progression over conventional parameters alone.
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Abbreviations
- CAD:
-
Coronary artery disease
- CCTA:
-
Coronary computed tomography angiography
- CPB:
-
Calcified plaque burden
- CPV:
-
Calcified plaque volume
- DS:
-
Diameter stenosis
- FAI:
-
Fat attenuation index
- FPB:
-
Fibrous plaque burden
- FPV:
-
Fibrous plaque volume
- LDL:
-
Low-density lipoprotein
- LL:
-
Lesion length
- LPB:
-
Lipid-rich plaque burden
- LPV:
-
Lipid-rich plaque volume
- NCPB:
-
Noncalcified plaque burden
- NCPV:
-
Non-calcified plaque volume
- PB:
-
Plaque burden
- RF:
-
Random forest
- TPB:
-
Total plaque burden
- TPV:
-
Total plaque volume
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Acknowledgements
The authors thank the other investigators, the staff, and the participants of this study for their valuable contributions.
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The scientific guarantor of this publication is Feiyun Wu.
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One of the authors of this manuscript (Shushen Lin) is an employee of Siemens Healthineers. The remaining authors declare no relationships with any companies whose products or services may be related to the subject matter of the article.
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• performed at one institution
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Feng, C., Chen, R., Dong, S. et al. Predicting coronary plaque progression with conventional plaque parameters and radiomics features derived from coronary CT angiography. Eur Radiol 33, 8513–8520 (2023). https://doi.org/10.1007/s00330-023-09809-4
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DOI: https://doi.org/10.1007/s00330-023-09809-4