Computed tomography angiography-based radiomics model to identify high-risk carotid plaques

Chao Chen; Wei Tang; Yong Chen; Wenhan Xu; Ningjun Yu; Chao Liu; Zenghui Li; Zhao Tang; Xiaoming Zhang

doi:10.21037/qims-23-158

Computed tomography angiography-based radiomics model to identify high-risk carotid plaques

Quant Imaging Med Surg. 2023 Sep 1;13(9):6089-6104. doi: 10.21037/qims-23-158. Epub 2023 Aug 14.

Authors

Chao Chen^#¹, Wei Tang^#¹, Yong Chen², Wenhan Xu¹, Ningjun Yu¹, Chao Liu¹, Zenghui Li¹, Zhao Tang¹, Xiaoming Zhang¹

Affiliations

¹ Medical Imaging Key Laboratory of Sichuan Province and Department of Radiology, Affiliated Hospital, North Sichuan Medical College, Nanchong, China.
² Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

^# Contributed equally.

Abstract

Background: Extracranial atherosclerosis is one of the major causes of stroke. Carotid computed tomography angiography (CTA) is a widely used imaging modality that allows detailed assessments of plaque characteristics. This study aimed to develop and test radiomics models of carotid plaques and perivascular adipose tissue (PVAT) to distinguish symptomatic from asymptomatic plaques and compare the diagnostic value between radiomics models and traditional CTA model.

Methods: A total of 144 patients with carotid plaques were divided into symptomatic and asymptomatic groups. The traditional CTA model was built by the traditional radiological features of carotid plaques measured on CTA images which were screened by univariate analysis and multivariable logistic regression. We extracted and screened radiomics features from carotid plaques and PVAT. Then, a support vector machine was used for building plaque and PVAT radiomics models, as well as a combined model using traditional CTA features and radiomics features. The diagnostic value between radiomics models and traditional CTA model was compared in identifying symptomatic carotid plaques by Delong method.

Results: The area under curve (AUC) values of traditional CTA model were 0.624 and 0.624 for the training and validation groups, respectively. The plaque radiomics model and PVAT radiomics model achieved AUC values of 0.766, 0.740 and 0.759, 0.618 in the two groups, respectively. Meanwhile, the combined model of plaque and PVAT radiomics features and traditional CTA features had AUC values of 0.883 and 0.840 for the training and validation groups, respectively, and the receiver operating characteristic curves of combined model were significantly better than those of traditional CTA model in the training group (P<0.001) and validation group (P=0.029).

Conclusions: The combined model of the radiomics features of carotid plaques and PVAT and the traditional CTA features significantly contributes to identifying high-risk carotid plaques compared with traditional CTA model.

Keywords: Radiomics; carotid plaques; computed tomography angiography (CTA); ischemic stroke; perivascular adipose tissue (PVAT).