Abstract
2220
Introduction: Coronary 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) and computed tomography (CT) angiography have shown promise in refining risk stratification in patients with coronary artery disease. On top of qualitative and quantitative atherosclerotic plaque characteristics coronary CT angiography can provide a wealth of radiomics features which can enhance the clinical utility of coronary CT angiography. Since the associations between latent morphological radiomic coronary plaque features and atherosclerotic disease activity evidenced on 18F-NaF remains largely unknown, in the current study we aimed to characterize the CT angiography derived radiomic predictors of 18F-NaF uptake.
Methods: Patients with known coronary artery disease underwent coronary 18F-NaF PET and CT angiography on a hybrid PET/CT scanner. Coronary 18F-NaF uptake was determined by the coronary microcalcification activity (CMA). Coronary plaque segmentations on CT angiography were analyzed using radiomics image analysis software. Overall, 1103 radiomic features were used to derive clusters of latent morphological patterns of coronary plaques using weighted correlation network analysis. The resulting radiomic patterns were associated with PET positivity (CMA>0) and CMA values using logistic and linear regression analysis respectively.
Results: Among 293 patients with established coronary artery disease (age: 65±9 years; 84% men), 203 (69%) showed increased coronary 18F-NaF activity (CMA >0). Following the principal component analysis the 1103 radiomic features were clustered into 14 distinct clusters representing latent morphological coronary plaque patterns. Of these clusters 9 were associated with CMA values and 10 were associated with PET positivity. However, several clusters representing plaque patterns were not associated with PET activity (Table).
Conclusions: Radiomic analysis of coronary CT angiography images allows identification of latent morphological features which are highly correlated with 18F-NaF coronary activity. Further research investigating the association of these features with outcomes is warranted
Table. Clustered radiomic coronary plaque features and coronary 18F-NaF uptake.