Prediction of Coronary Calcification and Stenosis: Role of Radiomics From Low-Dose CT

Abstract

Rationale and objectives: We aimed to assess relationship between single-click, whole heart radiomics from low-dose computed tomography (LDCT) for lung cancer screening with coronary artery calcification and stenosis.

Materials and methods: The institutional review board-approved, retrospective study included all 106 patients (68 men, 38 women, mean age 64 ± 7 years) who underwent both LDCT for lung cancer screening and had calcium scoring and coronary computed tomography angiography in our institution. We recorded the clinical variables including patients' demographics, smoking history, family history, and lipid profiles. Coronary calcium scores and grading of coronary stenosis were recorded from the radiology information system. We calculated the multiethnic scores for atherosclerosis risk scores to obtain 10-year coronary heart disease (MESA 10-Y CHD) risk of cardiovascular disease for all patients. Deidentified LDCT exams were exported to a Radiomics prototype for automatic heart segmentation, and derivation of radiomics. Data were analyzed using multiple logistic regression and kernel Fisher discriminant analyses.

Results: Whole heart radiomics were better than the clinical variables for differentiating subjects with different Agatston scores (≤400 and >400) (area under the curve [AUC] 0.92 vs 0.69). Prediction of coronary stenosis and MESA 10-Y CHD risk was better on whole heart radiomics (AUC:0.86-0.87) than with clinical variables (AUC:0.69-0.79). Addition of clinical variables or visual assessment of coronary calcification from LDCT to whole heart radiomics resulted in a modest change in the AUC.

Conclusion: Single-click, whole heart radiomics obtained from LDCT for lung cancer screening can differentiate patients with different Agatston and MESA risk scores for cardiovascular diseases.

Keywords: Coronary artery disease; Low dose CT; Lung Cancer Screening; Radiomics; Smoking.