Son Jinwoo, Hong Yoo Jin, Kim Sujeong, Han Kyunghwa, Lee Hye-Jeong, Hur Jin, Kim Young Jin, Choi Byoung Wook
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea.
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea.
Acad Radiol. 2022 Apr;29 Suppl 4:S1-S8. doi: 10.1016/j.acra.2020.12.009. Epub 2021 Jan 6.
Accurate differential diagnosis is essential because cardiac tumors and thrombi have different prognoses and therapeutic approaches. Native T1 map provides an objective T1 time quantifications of cardiac mass without the need for a contrast agent. We examined the diagnostic performance of radiomics features for differentiating cardiac tumors from thrombi using cardiac magnetic resonance imaging T1 mapping technique compared to that of late gadolinium enhancement (LGE) imaging.
This retrospective study included 22 cardiac tumors and 21 thrombi of 41 patients who underwent cardiac magnetic resonance imaging from December 2013 to May 2018. Fifty-six radiomics features were extracted from native T1 images. The least absolute shrinkage and selection operator method was used for feature selection and rad score extraction. The diagnostic performance of the rad score was compared to that of the native T1 value (mean T1) and LGE ratio.
The area under the receiver operating characteristic curve of the rad score was higher than that of the mean T1 and LGE ratio (0.98 vs. 0.86 vs. 0.82, p = 0.001). With the optimal cut-off value, the rad score showed sensitivity, specificity, and accuracy of 95.4%, 95.2%, and 95.2%, respectively. Combination of the rad score and mean T1 showed a significantly higher diagnostic performance than mean T1 (p = 0.019) or LGE ratio (p = 0.022).
The rad score derived from native T1 maps can differentiate thrombi from tumors better than the mean T1 or LGE ratio. This is valuable for determining a treatment strategy for cardiac lesions in patients who cannot tolerate contrast agents.
准确的鉴别诊断至关重要，因为心脏肿瘤和血栓具有不同的预后和治疗方法。基于T1加权成像的心肌定量分析（Native T1 map）可在无需使用造影剂的情况下，对心脏肿块进行客观的T1时间定量分析。我们使用心脏磁共振成像T1映射技术，与延迟钆增强（LGE）成像相比，研究了放射组学特征在鉴别心脏肿瘤与血栓方面的诊断性能。
这项回顾性研究纳入了2013年12月至2018年5月期间接受心脏磁共振成像检查的41例患者的22个心脏肿瘤和21个血栓。从基于T1加权成像的心肌定量分析（Native T1）图像中提取了56个放射组学特征。采用最小绝对收缩和选择算子法进行特征选择和放射组学评分（rad score）提取。将放射组学评分的诊断性能与基于T1加权成像的心肌定量分析（Native T1）值（平均T1）和LGE比率进行比较。
放射组学评分的受试者工作特征曲线下面积高于平均T1和LGE比率（0.98对0.86对0.82，p = 0.001）。在最佳临界值下，放射组学评分的敏感性、特异性和准确性分别为95.4%、95.2%和95.2%。放射组学评分与平均T1的组合显示出比平均T1（p = 0.019）或LGE比率（p = 0.022）显著更高的诊断性能。
基于T1加权成像的心肌定量分析（Native T1）图谱得出的放射组学评分在区分血栓和肿瘤方面优于平均T1或LGE比率。这对于为无法耐受造影剂的患者确定心脏病变的治疗策略具有重要价值。
