Automated plaque analysis for the prognostication of major adverse cardiac events
| Autor: | Taylor M. Duguay, Svetlana Egorova, Rozemarijn Vliegenthart, Matthijs Oudkerk, H. Todd Hudson, Kjell Johnson, U. Joseph Schoepf, Marly van Assen, Samantha St. Pierre, Andrew J. Buckler, Akos Varga-Szemes, Beatrice M. Zaki |
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| Přispěvatelé: | Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Cardiovascular Centre (CVC) |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
Computed Tomography Angiography COMPUTED-TOMOGRAPHY ANGIOGRAPHY Prognostication medicine.disease_cause Logistic regression Coronary Angiography Severity of Illness Index Coronary artery disease 030218 nuclear medicine & medical imaging 0302 clinical medicine Risk Factors ARTERY-DISEASE Computed tomography CORONARY CT ANGIOGRAPHY Computed tomography angiography medicine.diagnostic_test SHEAR-STRESS Area under the curve General Medicine Automated analysis ASSOCIATION Middle Aged Prognosis Plaque Atherosclerotic 030220 oncology & carcinogenesis Area Under Curve Cardiology Female ATHEROSCLEROTIC PLAQUE Algorithms medicine.medical_specialty MACE Discriminatory power 03 medical and health sciences VULNERABLE PLAQUE Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Retrospective Studies business.industry Plaque analysis medicine.disease Vulnerable plaque Stenosis HIGH-RISK ENDOTHELIAL DYSFUNCTION business CAROTID-ARTERY Mace |
| Zdroj: | European Journal of Radiology, 116, 76-83. ELSEVIER IRELAND LTD |
| ISSN: | 0720-048X |
| DOI: | 10.1016/j.ejrad.2019.04.013 |
| Popis: | Objective: The purpose of this study is to assess the value of an automated model-based plaque characterization tool for the prediction of major adverse cardiac events (MACE).Methods: We retrospectively included 45 patients with suspected coronary artery disease of which 16 (33%) experienced MACE within 12 months. Commercially available plaque quantification software was used to automatically extract quantitative plaque morphology: lumen area, wall area, stenosis percentage, wall thickness, plaque burden, remodeling ratio, calcified area, lipid rich necrotic core (LRNC) area and matrix area. The measurements were performed at all cross sections, spaced at 0.5 mm, based on fully 3D segmentations of lumen, wall, and each tissue type. Discriminatory power of these markers and traditional risk factors for predicting MACE were assessed.Results: Regression analysis using clinical risk factors only resulted in a prognostic accuracy of 63% with a corresponding area under the curve (AUC) of 0.587. Based on our plaque morphology analysis, minimal cap thickness, lesion length, LRNC volume, maximal wall area/thickness, the remodeling ratio, and the calcium volume were included into our prognostic model as parameters. The use of morphologic features alone resulted in an increased accuracy of 77% with an AUC of 0.94. Combining both clinical risk factors and morphological features in a multivariate logistic regression analysis increased the accuracy to 87% with a similar AUC of 0.924.Conclusion: An automated model based algorithm to evaluate CCTA-derived plaque features and quantify morphological features of atherosclerotic plaque increases the ability for MACE prognostication significantly compared to the use of clinical risk factors alone. |
| Databáze: | OpenAIRE |
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