Latent Coronary Plaque Morphology From Computed Tomography Angiography, Molecular Disease Activity on Positron Emission Tomography, and Clinical Outcomes.
Latent Coronary Plaque Morphology From Computed Tomography Angiography, Molecular Disease Activity on Positron Emission Tomography, and Clinical Outcomes.
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计算机断层扫描血管造影的潜在冠状动脉斑块形态、正电子发射断层扫描的分子疾病活动以及临床结果。
DOI：
10.1161/atvbaha.123.319332
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发表时间：
2023
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通讯作者：
Kwiecinski J
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作者：
Kwiecinski J
背景：用18f -氟化钠正电子发射断层扫描和基于放射组学的精确冠状动脉斑块表型评估冠状动脉疾病的活度可能会增强冠状动脉疾病患者的风险分层。我们试图研究这两种方法提供的预后信息在预测心肌梗死时是否互补。方法已知冠心病患者在正电子发射断层/计算机断层混合扫描仪上行冠状动脉18f -氟化钠正电子发射断层扫描和冠状动脉计算机断层血管造影。冠状动脉微钙化活性测定冠状动脉18f - naf摄取。我们对冠状动脉计算机断层血管造影数据集进行了定量斑块分析，并为每个斑块提取了1103个放射学特征。通过加权相关网络分析，我们得到了冠状动脉病变的潜在形态学特征，这些特征被聚合到患者水平的放射组学图中，以预测心肌梗死。结果260例确诊冠心病患者（年龄65±9岁，83%为男性）中，179例（69%）出现冠状动脉18f - naf活性升高（冠状动脉微钙化活性>）。在53（40-59）个月的随访中，18例患者发生心肌梗死。使用加权相关网络分析，我们以无监督的方式导出了15个不同的特征放射学特征，代表潜在的形态冠状动脉斑块模式。在调整钙化、非钙化和低密度非钙化斑块体积和18f - naf冠状动脉微钙化活性后，4个放射学特征仍然是心肌梗死的独立预测因子（风险比1.46 [95% CI, 1.03-2.08]；P=0.03；风险比1.62 [95% CI, 1.04-2.54]；P=0.02；风险比1.49 [95% CI, 1.07-2.06]；P=0.01；风险比1.50 (95% CI, 1.05-2.13)；P=0.02）。结论在确诊的冠心病患者中，18f -氟化钠正电子发射断层扫描显示的潜在冠状动脉斑块形态特征、定量斑块体积和疾病活动性是心肌梗死的附加预测因素。
BackgroundAssessments of coronary disease activity with18F-sodium fluoride positron emission tomography and radiomics-based precision coronary plaque phenotyping derived from coronary computed tomography angiography may enhance risk stratification in patients with coronary artery disease. We sought to investigate whether the prognostic information provided by these 2 approaches is complementary in the prediction of myocardial infarction.MethodsPatients with known coronary artery disease underwent coronary18F-sodium fluoride positron emission tomography and coronary computed tomography angiography on a hybrid positron emission tomography/computed tomography scanner. Coronary18F-NaF uptake was determined by the coronary microcalcification activity. We performed quantitative plaque analysis of coronary computed tomography angiography datasets and extracted 1103 radiomic features for each plaque. Using weighted correlation network analysis, we derived latent morphological features of coronary lesions which were aggregated to patient-level radiomics nomograms to predict myocardial infarction.ResultsAmong 260 patients with established coronary artery disease (age, 65±9 years; 83% men), 179 (69%) participants showed increased coronary18F-NaF activity (coronary microcalcification activity>0). Over 53 (40–59) months of follow-up, 18 patients had a myocardial infarction. Using weighted correlation network analysis, we derived 15 distinct eigen radiomic features representing latent morphological coronary plaque patterns in an unsupervised fashion. Following adjustments for calcified, noncalcified, and low-density noncalcified plaque volumes and18F-NaF coronary microcalcification activity, 4 radiomic features remained independent predictors of myocardial infarction (hazard ratio, 1.46 [95% CI, 1.03–2.08];P=0.03; hazard ratio, 1.62 [95% CI, 1.04–2.54];P=0.02; hazard ratio, 1.49 [95% CI, 1.07–2.06];P=0.01; and hazard ratio, 1.50 (95% CI, 1.05–2.13);P=0.02).ConclusionsIn patients with established coronary artery disease, latent coronary plaque morphological features, quantitative plaque volumes, and disease activity on18F-sodium fluoride positron emission tomography are additive predictors of myocardial infarction.