Abstract 12353: Unveiling the Hidden Insights: Cardiac Magnetic Resonance Radiomics Signature of the Myocardial Disease in Non-Ischemic Dilated Cardiomyopathy

Abstract

Background: There is a growing interest in CMR radiomic signatures as novel imaging biomarkers of cardiac diseases. The relationship between CMR radiomic signatures and myocardial tissue composition is unknown. Goal: To investigate the association of CMR myocardial radiomic signatures to histological features in non-ischemic dilated cardiomyopathy (DCM). Methods: CMR images from 132 DCM patients (71% male; 54±15 years) who underwent CMR and endomyocardial biopsy within 6 [2-15] days were used to investigate the association between myocardial radiomic signatures measured from native T 1 , extra-cellular volume (ECV), LGE and histological features. Radiomic first-order and textural features were computed for each sequence from the mid-septal myocardium near the biopsy region (1023 features). We applied consensus clustering to identify distinct radiomic clusters. A single representative feature, the medoid, was identified within each cluster based on its minimal dissimilarity from other features. We built logistic regression models using one medoid per model to assess the association between each medoid and histological features. Results: Clustering analysis unveiled three radiomic clusters for each sequence. For native T 1 , the medoids were textural features, with medoids 1 and 2 exhibiting associations with fibrosis and myocyte hypertrophy (AUC of 0.71/0.74 and 0.78/0.69, respectively). ECV medoids included first-order and textural features. The first-order medoid was associated with myocyte hypertrophy (AUC=0.75), while medoid 3 (texture) was associated with fat replacement (AUC=0.81). LGE medoid 1 (first-order) was associated with inflammation (AUC=0.61) and vacuolization (AUC=0.76), while medoid 3 (texture), associated with fibrosis (AUC=0.69) and fat replacement (AUC=0.67) ( Figure 1 ). Conclusions: In DCM patients, CMR radiomic features were associated with myocardial tissue composition, as assessed by invasive biopsy.