Assessing robustness of carotid artery CT angiography radiomics in the identification of culprit lesions in cerebrovascular events.

Journal: Scientific reports
PMID:

Abstract

Radiomics, quantitative feature extraction from radiological images, can improve disease diagnosis and prognostication. However, radiomic features are susceptible to image acquisition and segmentation variability. Ideally, only features robust to these variations would be incorporated into predictive models, for good generalisability. We extracted 93 radiomic features from carotid artery computed tomography angiograms of 41 patients with cerebrovascular events. We tested feature robustness to region-of-interest perturbations, image pre-processing settings and quantisation methods using both single- and multi-slice approaches. We assessed the ability of the most robust features to identify culprit and non-culprit arteries using several machine learning algorithms and report the average area under the curve (AUC) from five-fold cross validation. Multi-slice features were superior to single for producing robust radiomic features (67 vs. 61). The optimal image quantisation method used bin widths of 25 or 30. Incorporating our top 10 non-redundant robust radiomics features into ElasticNet achieved an AUC of 0.73 and accuracy of 69% (compared to carotid calcification alone [AUC: 0.44, accuracy: 46%]). Our results provide key information for introducing carotid CT radiomics into clinical practice. If validated prospectively, our robust carotid radiomic set could improve stroke prediction and target therapies to those at highest risk.

Authors

  • Elizabeth P V Le
    Department of Medicine, University of Cambridge, Cambridge, UK.
  • Leonardo Rundo
    Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK; Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge CB2 0RE, UK. Electronic address: lr495@cam.ac.uk.
  • Jason M Tarkin
    Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK jt545@cam.ac.uk.
  • Nicholas R Evans
    Department of Medicine, University of Cambridge, Cambridge, UK.
  • Mohammed M Chowdhury
    Division of Vascular Surgery, Department of Surgery, University of Cambridge, Cambridge, UK.
  • Patrick A Coughlin
    Division of Vascular Surgery, Department of Surgery, University of Cambridge, Cambridge, UK.
  • Holly Pavey
    Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK.
  • Chris Wall
    Department of Medicine, University of Cambridge, Cambridge, UK.
  • Fulvio Zaccagna
  • Ferdia A Gallagher
  • Yuan Huang
    School of Electrical Engineering and Information, Sichuan University, Chengdu 610065, China.
  • Rouchelle Sriranjan
    Department of Medicine, University of Cambridge, Cambridge, UK.
  • Anthony Le
    School of Medicine, University of Leeds, Leeds, UK.
  • Jonathan R Weir-McCall
    Department of Radiology, University of Cambridge, Cambridge, UK.
  • Michael Roberts
    EPSRC Centre for Mathematical Imaging in Healthcare, University of Cambridge, Cambridge, UK.
  • Fiona J Gilbert
    Department of Radiology, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom; NIHR Cambridge Biomedical Research Center, Cambridge, United Kingdom.
  • Elizabeth A Warburton
    Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
  • Carola-Bibiane Schönlieb
    EPSRC Centre for Mathematical Imaging in Healthcare, University of Cambridge, Cambridge, UK.
  • Evis Sala
    Department of Radiology and Cancer Research UK Cambridge Centre, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, England.
  • James H F Rudd
    Department of Cardiovascular Medicine, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.