Shang Jin, Guo Yan, Ma Yue, Hou Yang
Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.
GE Healthcare, Beijing, China.
Quant Imaging Med Surg. 2022 Jun;12(6):3436-3453. doi: 10.21037/qims-21-1022.
In an era of profound growth of medical data and rapid development of advanced imaging modalities, precision medicine increasingly requires further expansion of what can be interpreted from medical images. However, the current interpretation of cardiac computed tomography (CT) images mainly depends on subjective and qualitative analysis. Radiomics uses advanced image analysis to extract numerous quantitative features from digital images that are unrecognizable to the naked eye. Visualization of these features can reveal underlying connections between image phenotyping and biological characteristics and support clinical outcomes. Although research into radiomics on cardiovascular disease began only recently, several studies have indicated its potential clinical value in assessing future cardiac risk and guiding prevention and management strategies. Our review aimed to summarize the current applications of cardiac CT radiomics in the cardiovascular field and discuss its advantages, challenges, and future directions.
We searched for English-language articles published between January 2010 and August 2021 in the databases of PubMed, Embase, and Google Scholar. The keywords used in the search included computed tomography or CT, radiomics, cardiovascular or cardiac.
The current applications of radiomics in cardiac CT were found to mainly involve research into coronary plaques, perivascular adipose tissue (PVAT), myocardial tissue, and intracardiac lesions. Related findings on cardiac CT radiomics suggested the technique can assist the identification of vulnerable plaques or patients, improve cardiac risk prediction and stratification, discriminate myocardial pathology and etiologies behind intracardiac lesions, and offer new perspective and development prospects to personalized cardiovascular medicine.
Cardiac CT radiomics can gather additional disease-related information at a microstructural level and establish a link between imaging phenotyping and tissue pathology or biology alone. Therefore, cardiac CT radiomics has significant clinical implications, including a contribution to clinical decision-making. Along with advancements in cardiac CT imaging, cardiac CT radiomics is expected to provide more precise phenotyping of cardiovascular disease for patients and doctors, which can improve diagnostic, prognostic, and therapeutic decision making in the future.
在医学数据深度增长和先进成像模式快速发展的时代，精准医学越来越需要进一步拓展从医学图像中所能解读的内容。然而，目前心脏计算机断层扫描（CT）图像的解读主要依赖主观和定性分析。放射组学利用先进的图像分析技术从肉眼无法识别的数字图像中提取大量定量特征。这些特征的可视化可以揭示图像表型与生物学特征之间的潜在联系，并支持临床结果。尽管心血管疾病放射组学的研究才刚刚起步，但多项研究已表明其在评估未来心脏风险以及指导预防和管理策略方面的潜在临床价值。我们的综述旨在总结心脏CT放射组学在心血管领域的当前应用，并讨论其优势、挑战和未来方向。
我们在PubMed、Embase和谷歌学术数据库中检索了2010年1月至2021年8月发表的英文文章。检索所用关键词包括计算机断层扫描或CT、放射组学、心血管或心脏。
发现放射组学在心脏CT中的当前应用主要涉及对冠状动脉斑块、血管周围脂肪组织（PVAT）、心肌组织和心内病变的研究。心脏CT放射组学的相关发现表明，该技术可辅助识别易损斑块或患者，改善心脏风险预测和分层，鉴别心内病变背后的心肌病理和病因，并为个性化心血管医学提供新的视角和发展前景。
心脏CT放射组学可以在微观结构水平收集额外的疾病相关信息，并单独建立成像表型与组织病理学或生物学之间的联系。因此，心脏CT放射组学具有重要的临床意义，包括对临床决策的贡献。随着心脏CT成像技术的进步，心脏CT放射组学有望为患者和医生提供更精确的心血管疾病表型分析，从而在未来改善诊断、预后和治疗决策。
