Radiomics Analysis of CTO Plaques for Predicting Successful Guidewire Crossing Within 30 Minutes of PCI.

IF 6.5 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Circulation: Cardiovascular Imaging Pub Date : 2024-08-01 Epub Date: 2024-08-20 DOI:10.1161/CIRCIMAGING.123.016117

Haoran Xing, Zhenchao Tang, Lijun Zhang, Zhenyu Liu, Yang Liu, Xu Fu, Ouya Lin, Qiang Wang, Dongfeng Zhang, Lanxin Feng, Min Zhang, Feng Xu, Mingduo Zhang, Yuan Zhou, Yuan Fu, Chuang Li, Li Xu, Yi He, Hongjia Zhang, Xiantao Song, Jiangang Liu

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Abstract

Background: Coronary computed tomography angiography provides valuable information for evaluating the difficulty of chronic total occlusion (CTO) percutaneous coronary intervention. This study aimed to investigate the value of CTO plaque characteristics derived from radiomics analysis for predicting the difficulty of percutaneous coronary intervention.

Methods: Patients with CTO were retrospectively enrolled from a hospital as training and internal test sets and from the other 2 territory hospitals as external test sets. Radiomics characteristics were extracted from the CTO segment on coronary computed tomography angiography. Radiomics and combined models were developed to predict successful guidewire crossing within 30 minutes (guidewire success) of CTO percutaneous coronary intervention. Subgroup analysis was conducted to investigate the influence of potential risk factors on the radiomics model performance.

Results: A total of 551 patients (median, 60; interquartile range, 52.00-66.00 years, 460 men) with 565 CTO lesions were finally enrolled. In the training, internal test, and external test sets, 203 of 357, 85 of 149, and 38 of 59 CTO lesions achieved guidewire success, respectively. Six radiomics features were selected for constructing the radiomics model. In the external test set, the area under the receiver operating characteristic curve of the radiomics model was significantly higher than prior prediction models (P<0.05 for all) with the area under the receiver operating characteristic curve, accuracy, sensitivity, and specificity of 0.86, 74.58%, 81.58%, and 61.90%, respectively. The performance of the radiomics model was dependent on calcification, CTO location, adjacent branch(es), and operator caseload.

Conclusions: CTO characteristics revealed by radiomics analysis can be used as effective imaging biomarkers for predicting guidewire success. However, the performance of the radiomics model depends on anatomic and operator factors.

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通过对 CTO 斑块进行放射组学分析，预测 PCI 术后 30 分钟内导丝穿刺是否成功。

背景：冠状动脉计算机断层扫描血管造影为评估慢性全闭塞（CTO）经皮冠状动脉介入治疗的难度提供了有价值的信息。本研究旨在探讨放射组学分析得出的 CTO 斑块特征对预测经皮冠状动脉介入治疗难度的价值：方法：回顾性招募一家医院的 CTO 患者作为训练集和内部测试集，另外两家地区医院的患者作为外部测试集。从冠状动脉计算机断层扫描血管造影的 CTO 截面提取放射组学特征。开发了放射组学模型和组合模型，用于预测 CTO 经皮冠状动脉介入治疗 30 分钟内导丝穿刺成功率（导丝穿刺成功率）。为研究潜在风险因素对放射组学模型性能的影响，进行了分组分析：共有 551 名患者（中位数，60 岁；四分位数区间，52.00-66.00 岁，460 名男性）最终入选，其中有 565 个 CTO 病变。在训练集、内部测试集和外部测试集中，357 个 CTO 病灶中分别有 203 个、149 个病灶中的 85 个和 59 个病灶中的 38 个取得了导丝成功。构建放射组学模型时选择了六个放射组学特征。在外部测试集中，放射组学模型的接收者操作特征曲线下面积明显高于之前的预测模型（PConclusions：放射组学分析所揭示的 CTO 特征可作为预测导丝成功率的有效成像生物标志物。然而，放射组学模型的性能取决于解剖和操作者因素。

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.