用深度学习从普通心脏CT预测心血管风险，10年预测效果优于传统方法。
CARDINAL Predicts Cardiovascular Risk From Non-contrast Cardiac CT
- 通过嵌套解剖结构的深度表征学习，从非增强心脏CT提取紧凑特征
- 10年MACE预测AUROC达0.866，显著高于传统影像特征的0.826
- 适合临床心血管风险评估，尤其适用于长期预后预测
心血管风险预测受限于不完整的临床数据和仅能提取少量手工特征的影像生物标志物。我们开发了CARDINAL（基于深度影像嵌入的解剖结构嵌套表征的心血管评估），一种从常规非增强心脏CT中学习紧凑表示以预测主要不良心血管事件（MACE）的临床导向框架。在17,659名患者中，CARDINAL在1、3、5、10年MACE预测上对比美国心脏协会（AHA） pooled cohort equations（PCE）、PREVENT、冠状动脉钙化（CAC）、分割衍生的CT生物标志物及70个特征的结构放射组学进行了评估。长期预测收益最大。10年时，CARDINAL联合模型的受试者工作特征曲线下面积（AUROC）为0.866 ± 0.020，精确率-召回率曲线下面积（AUPRC）为0.890 ± 0.015，优于结构放射组学的AUROC 0.826 ± 0.023和AUPRC 0.826 ± 0.022。CARDINAL还获得最高生存一致性指数（C-index）0.753 ± 0.015，高危与低危三分类的危险比达10.78 ± 3.16，且具有良好的重新分类能力和探索性校准。结果表明，非增强心脏CT包含超越传统风险方程、CAC评分和工程化影像标志物的预后信息。
原文摘要 · Abstract (English)
Cardiovascular risk prediction remains limited by incomplete clinical data and imaging biomarkers that reduce computed tomography (CT) to a small number of handcrafted features. We developed CARDINAL (Cardiovascular Assessment via Representation learning from Deep Imaging with Nested Anatomical Latent embeddings), a clinically grounded framework that learns compact representations from routine non-contrast cardiac CT for major adverse cardiovascular event (MACE) prediction. In 17,659 patients, CARDINAL was evaluated for 1-, 3-, 5-, and 10-year MACE prediction against American Heart Association (AHA) pooled cohort equations (PCE), AHA predicting risk of cardiovascular disease events (PREVENT), coronary artery calcium (CAC), segmentation-derived CT biomarkers, and 70-feature structural radiomics. Gains were largest at longer horizons. At 10 years, CARDINAL (joint) achieved an area under the receiver operating characteristic curve (AUROC) of 0.866 $\pm$ 0.020 and an area under the precision-recall curve (AUPRC) of 0.890 $\pm$ 0.015, compared with an AUROC of 0.826 $\pm$ 0.023 and an AUPRC of 0.826 $\pm$ 0.022 for structural radiomics, the strongest baseline. CARDINAL also achieved the highest survival concordance index (C-index), 0.753 $\pm$ 0.015, and high-versus-low risk-tertile hazard ratio, 10.78 $\pm$ 3.16, with favorable reclassification and exploratory calibration. These findings suggest that non-contrast cardiac CT contains prognostic information beyond conventional risk equations, CAC scoring, and engineered imaging biomarkers.
Thank you to arXiv for use of its open access interoperability. PaperDance 不是 arXiv 官方产品；中文卡片由大模型生成，请以原文为准。