Pericoronary radiomics texture features associated with hypercholesterolemia on a photon-counting-CT

Abstract

IntroductionPericoronary adipose tissue (PCAT) stands in complex bidirectional interaction with the surrounding arteries and is known to be connected to many cardiovascular diseases involving vascular inflammation. PCAT texture may be influenced by other cardiovascular risk factors such as hypercholesterolemia. The recently established photon-counting CT could improve texture analysis and help detect those changes by offering higher spatial resolution and signal-to-noise ratio.MethodsIn this retrospective, single-center, IRB-approved study, PCAT of the left and right coronary artery was manually segmented and radiomic features were extracted using pyradiomics. The study population consisted of a test collective and a validation collective. The collectives were each divided into two groups defined by the presence or absence of hypercholesterolemia, taken from self-reported conditions and confirmed by medical records. Mean and standard deviation were calculated with Pearson correlation coefficient for correlation of features and visualized as boxplots and heatmaps using R statistics. Random forest feature selection was performed to identify differentiating features between the two groups. 66 patients were enrolled in this study (34 female, mean age 58 years).ResultsTwo radiomics features allowing differentiation between PCAT texture of the groups were identified (p-values between 0.013 and 0.24) and validated. Patients with hypercholesterolemia presented with a greater concentration of high-density values as indicated through analysis of specific texture features as “gldm_HighGrayLevelEmphasis” (23.95 vs. 22.99) and “glrlm_HighGrayLevelRunEmphasis” (24.21 vs. 23.31).DiscussionTexture analysis of PCAT allowed differentiation between patients with and without hypercholesterolemia offering a potential imaging biomarker for this specific cardiovascular risk factor.

Analysis of Epicardial Adipose Tissue Texture in Relation to Coronary Artery Calcification in PCCT: The EAT Signature!

“…As a well-established tool in oncology research, the use of radiomics in the field of cardiovascular imaging, especially regarding cardiac adipose tissues and their texture, may offer extended diagnostic value in the future. In 2023, Kahmann et al [40] investigated changes in pericoronary adipose tissue in patients with hypercholesterolemia using radiomics analysis. The pericoronary adipose tissue of the left and right coronary arteries were segmented manually.…”

“…Using Random Forest feature selection, the most important features for differentiation between patients with and without hypercholesterolemia were identified and the four most important features were investigated in the validation collective. They identified two radiomics features to differ between patients with hypercholesterolemia and those without, offering a potential imaging biomarker [40].…”

“…Although the newly established PCCT offers increased image quality [42] and is more stable in texture analysis [28], the number of patients was severely limited by the selection criteria and the limited number of patients that were scanned on a PCCT. Different clinical risk factors such as e.g., hypercholesterolemia as mentioned above [40] seem to influence the texture of cardiac adipose tissues, which must be considered in future radiomics studies of adipose tissue texture. Due to the outpatient setting and the retrospective nature of this study, we were unable to account for sufficient clinical parameters.…”