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CT texture-based radiomics analysis of carotid arteries identifies vulnerable patients: a preliminary outcome study
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CT texture-based radiomics analysis of carotid arteries identifies vulnerable patients: a preliminary outcome study
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Journal Article
CT texture-based radiomics analysis of carotid arteries identifies vulnerable patients: a preliminary outcome study
2021
Overview
Purpose
To assess the potential role of computed tomography (CT) texture analysis (CTTA) in identifying vulnerable patients with carotid artery atherosclerosis.
Methods
In this case-control pilot study, 12 patients with carotid atherosclerosis and a subsequent history of transient ischemic attack or stroke were age and sex matched with 12 control cases with asymptomatic carotid atherosclerosis (follow-up time 103.58 ± 9.2 months). CTTA was performed using a commercially available research software package (TexRAD) by an operator blinded to clinical data. CTTA comprised a filtration-histogram technique to extract features at different scales corresponding to spatial scale filter (fine = 2 mm, medium = 3 mm, coarse = 4 mm), followed by quantification using histogram-based statistical parameters: mean, kurtosis, skewness, entropy, standard deviation, and mean value of positive pixels. A single axial slice was selected to best represent the largest cross-section of the carotid bifurcation or the greatest degree of stenosis, in presence of an atherosclerotic plaque, on each side.
Results
CTTA revealed a statistically significant difference in skewness between symptomatic and asymptomatic patients at the medium (0.22 ± 0.35 vs − 0.18 ± 0.39,
p
< 0.001) and coarse (0.23 ± 0.22 vs 0.03 ± 0.29,
p
= 0.003) texture scales. At the fine-texture scale, skewness (0.20 ± 0.59 vs − 0.18 ± 0.58,
p
= 0.009) and standard deviation (366.11 ± 117.19 vs 300.37 ± 82.51,
p
= 0.03) were significant before correction.
Conclusion
Our pilot study highlights the potential of CTTA to identify vulnerable patients in stroke and TIA. CT texture may have the potential to act as a novel risk stratification tool in patients with carotid atherosclerosis.
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