Prediction of incident cardiovascular events using machine learning and CMR radiomics
Esmeralda Ruiz Pujadas, Zahra Raisi-Estabragh, Liliana Szabo, Celeste McCracken, Cristian Izquierdo Morcillo, Víctor M Campello, Carlos Martín-Isla, Angelica M Atehortua, Hajnalka Vago, Bela Merkely, Pal Maurovich-Horvat, Nicholas C Harvey, Stefan Neubauer, Steffen E Petersen, Karim Lekadir
Eur Radiol . 2022 Dec 13. doi: 10.1007/s00330-022-09323-z. Online ahead of print.
Objectives: Evaluation of the feasibility of using cardiovascular magnetic resonance (CMR) radiomics in the prediction of incident atrial fibrillation (AF), heart failure (HF), myocardial infarction (MI), and stroke using machine learning techniques.
Methods: We identified participants from the UK Biobank who experienced incident AF, HF, MI, or stroke during the continuous longitudinal follow-up. The CMR indices and the vascular risk factors (VRFs) as well as the CMR images were obtained for each participant. Three-segmented regions of interest (ROIs) were computed: right ventricle cavity, left ventricle (LV) cavity, and LV myocardium in end-systole and end-diastole phases. Radiomics features were extracted from the 3D volumes of the ROIs. Seven integrative models were built for each incident cardiovascular disease (CVD) as an outcome. Each model was built with VRF, CMR indices, and radiomics features and a combination of them. Support vector machine was used for classification. To assess the model performance, the accuracy, sensitivity, specificity, and AUC were reported.
Results: AF prediction model using the VRF+CMR+Rad model (accuracy: 0.71, AUC 0.76) obtained the best result. However, the AUC was similar to the VRF+Rad model. HF showed the most significant improvement with the inclusion of CMR metrics (VRF+CMR+Rad: 0.79, AUC 0.84). Moreover, adding only the radiomics features to the VRF reached an almost similarly good performance (VRF+Rad: accuracy 0.77, AUC 0.83). Prediction models looking into incident MI and stroke reached slightly smaller improvement.
Conclusions: Radiomics features may provide incremental predictive value over VRF and CMR indices in the prediction of incident CVDs.