To estimate the utility of pre-procedural CT-radiomic analysis of epicardial adipose tissue (EAT), and to identify patients at risk for isolated atrial fibrillation (AF) recurrence after catheter ablation (CA).
The study population (63 patients) consisted of study group (Group 1) and comparative group (Group 2). 43 patients with isolated AF referred for CA. Before CA, all of them underwent multidetector computed tomography coronary angiography. Segmentation and subsequent radiomic analysis of EAT were performed on calcium scoring series of 3D DICOM images using by 3D-Slicer.
Epicardial adipose tissue in patients with isolated AF had a distinct radiomic phenotype. Thus, 45 of 93 calculated radiomic parameters of EAT, as well as EAT volume and attenuation, were significantly different between patients with isolated AF (Group 1) and persons without any arrhythmia (Group 2). Moreover, 17 radiomic parameters were significantly different in subgroups with and without AF recurrence (Group 1a and Group 1b). Multivariate regression analysis demonstrated that among all radiomic parameters only Gray Level Non-Uniformity Normalized (GLSZM) was an independent predictor of AF recurrence (OR 0.10027, 95%CI 1.0009-1.0044, p=0.002). ROC-curve analysis data showed that GLSZM >1227.4 indicates high probability of AF recurrence during 12 months (sensitivity 89.4 %, specificity 70.8 %, AUC: 0.809; p=0.001).
The radiomic parameter GLSZM is associated with late AF recurrence after CA in patients with isolated AF. In current study GLSZM was a stronger predictor of isolated AF recurrence in multivariate analysis comparing with other established risk factors and EAT volume and attenuation.