皮质氧合模式可预测肾动脉狭窄患者对支架植入术的反应:基于放射组学的模型

IF 4.2 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiovascular Magnetic Resonance Pub Date : 2024-06-01 Epub Date: 2024-01-11 DOI:10.1016/j.jocmr.2024.100993
Behzad Ebrahimi, Deep Gandhi, Mina H Alsaeedi, Lilach O Lerman
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引用次数: 0

摘要

背景:经皮穿刺肾血管成形术(PTRA)和支架植入术旨在阻止肾动脉狭窄(RAS)患者肾脏疾病的进展,但其结果往往不尽如人意。我们假设,利用放射组学分析血液氧合水平依赖性(BOLD)-MRI 图像提取的肾功能和氧合标志物模型可以预测猪 RAS 对 PTRA 的肾脏反应:在 PTRA 之前和之后 4 周,对 20 头患有 RAS 的家猪进行 CT 和 BOLD MRI 扫描。测定了狭窄肾(STK)和对侧肾(CLK)的体积、血流量(RBF)和肾小球滤过率(GFR),并在服用呋塞米(一种肾小管重吸收抑制剂)前后生成了 BOLD-MRI R2* 图。从PTRA前的BOLD图中提取放射组学特征,并通过类内相关系数(ICC)确定鲁棒特征。根据基线功能和 BOLD 放射组学特征开发了预测模型,使用 Lasso 回归进行训练,并使用重采样进行测试:结果:26 个放射组学特征通过了稳健性测试。STK 氧合分布模式对呋塞米无反应,而在 CLK 中,对氧合异质性敏感的放射组学特征有所下降。基于放射组学模型预测的 PTRA 术后 GFR(r=0.58,p=0.007)和 RBF(r=0.68;p=0.001)与实际测量结果相关,灵敏度和特异度分别为 92% 和 67%。模型无法成功预测PTRA后肾功能的系统测量结果:结论:一些放射组学特征对皮质氧合模式很敏感,可用于估算PTRA术后的肾功能,从而区分可能对PTRA和支架术有反应的受试者。
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Patterns of cortical oxygenation may predict the response to stenting in subjects with renal artery stenosis: A radiomics-based model.

Background: Percutaneous-transluminal renal angioplasty (PTRA) and stenting aim to halt the progression of kidney disease in patients with renal artery stenosis (RAS), but its outcome is often suboptimal. We hypothesized that a model incorporating markers of renal function and oxygenation extracted using radiomics analysis of blood oxygenation-level dependent (BOLD)-MRI images may predict renal response to PTRA in swine RAS.

Materials and methods: Twenty domestic pigs with RAS were scanned with CT and BOLD MRI before and 4 weeks after PTRA. Stenotic (STK) and contralateral (CLK) kidney volume, blood flow (RBF), and glomerular filtration rate (GFR) were determined, and BOLD-MRI R2 * maps were generated before and after administration of furosemide, a tubular reabsorption inhibitor. Radiomics features were extracted from pre-PTRA BOLD maps and Robust features were determined by Intraclass correlation coefficients (ICC). Prognostic models were developed to predict post-PTRA renal function based on the baseline functional and BOLD-radiomics features, using Lasso-regression for training, and testing with resampling.

Results: Twenty-six radiomics features passed the robustness test. STK oxygenation distribution pattern did not respond to furosemide, whereas in the CLK radiomics features sensitive to oxygenation heterogeneity declined. Radiomics-based model predictions of post-PTRA GFR (r = 0.58, p = 0.007) and RBF (r = 0.68; p = 0.001) correlated with actual measurements with sensitivity and specificity of 92% and 67%, respectively. Models were unsuccessful in predicting post-PTRA systemic measures of renal function.

Conclusions: Several radiomics features are sensitive to cortical oxygenation patterns and permit estimation of post-PTRA renal function, thereby distinguishing subjects likely to respond to PTRA and stenting.

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来源期刊
CiteScore
10.90
自引率
12.50%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.
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