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Texture analysis of SPECT myocardial perfusion provides prognostic value for dilated cardiomyopathy

Journal of Nuclear Cardiology volume 30, pages 504–515 (2023)Cite this article

Abstract

Background

Texture analysis (TA) has demonstrated clinical values in extracting information, quantifying inhomogeneity, evaluating treatment outcomes, and predicting long-term prognosis for cardiac diseases. The aim of this study was to explore whether TA of SPECT myocardial perfusion could contribute to improving the prognosis of dilated cardiomyopathy (DCM) patients.

Methods

Eighty-eight patients were recruited in our study between 2009 and 2020 who were diagnosed with DCM and underwent single-photon emission tomography myocardial perfusion imaging (SPECT MPI). Forty TA features were obtained from quantitative analysis of SPECT imaging in subjects with myocardial perfusion at rest. All patients were divided into two groups: the all-cause death group and the survival group. The prognostic value of texture parameters was assessed by Cox regression and Kaplan–Meier analysis.

Results

Twenty-five all-cause deaths (28.4%) were observed during the follow-up (39.2±28.7 months). Compared with the survival group, NT-proBNP and total perfusion deficit (TPD) were higher and left ventricular ejection fraction (LVEF) was lower in the all-cause death group. In addition, 26 out of 40 texture parameters were significantly different between the two groups. Univariate Cox regression analysis revealed that NT-proBNP, LVEF, and 25 texture parameters were significantly associated with all-cause death. The multivariate Cox regression analysis showed that low gray-level emphasis (LGLE) (P = 0.010, HR = 4.698, 95% CI 1.457–15.145) and long-run low gray-level emphasis (LRLGE) (P =0.002, HR = 6.085, 95% CI 1.906–19.422) were independent predictors of the survival outcome. When added to clinical parameters, LVEF, TPD, and TA parameters, including LGLE and LRLGE, were incrementally associated with all-cause death (global chi-square statistic of 26.246 vs. 33.521; P = 0.028, global chi-square statistic of 26.246 vs. 34.711; P = 0.004).

Conclusion

TA based on gated SPECT MPI could discover independent prognostic predictors of all-cause death in medically treated patients with DCM. Moreover, TA parameters, including LGLE and LRLGE, independent of the total perfusion deficit of the cardiac myocardium, appeared to provide incremental prognostic value for DCM patients.

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Abbreviations

SPECT MPI:

Single-photon emission tomography myocardial perfusion imaging

LVEF:

Left ventricular ejection fraction

TPD:

Total perfusion deficit

TA:

Texture analysis

DCM:

Dilated cardiomyopathy

GLRLM:

Gray-level run-length matrix

LGLE:

Low gray-level emphasis

LRLGE:

Long-run low gray-level emphasis

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Disclosures

Cheng Wang, Ying Ma, Yanyun Liu, Longxi Li, Chang Cui, Huiyuan Qin, Zhongqiang Zhao, Chunxiang Li, Weizhu Ju, Minglong Chen, Dianfu Li, and Weihua Zhou declare that there are no conflict of interest.

Funding

This research was supported by a grant from the American Heart Association (Project Number: 17AIREA33700016, PI: Weihua Zhou), a new faculty Grant from Michigan Technological University Institute of Computing and Cybersystems (PI: Weihua Zhou), and Grants from the National Nature Science Foundation of China (81900295 and 82100338) and the Natural Science Foundation of Jiangsu Province (BK 20191071).

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Author notes

  1. Cheng Wang and Ying Ma have contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China

    Cheng Wang MD, Ying Ma BS, Chang Cui MD, Huiyuan Qin MD, Zhongqiang Zhao BS, Chunxiang Li BS, Weizhu Ju MD, Minglong Chen MD & Dianfu Li MD

  2. Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Shaanxi, 710126, China

    Yanyun Liu MS

  3. School of Computer and Communication Engineering, Zhengzhou University of Light Industry, Zhengzhou, China

    Longxi Li BS

  4. Department of Applied Computing, Michigan Technological University, 1400 Townsend Dr, Houghton, MI, 49931, USA

    Weihua Zhou PhD

  5. Center for Biocomputing and Digital Health, Institute of Computing and Cybersystems, and Health Research Institute, Michigan Technological University, Houghton, USA

    Weihua Zhou PhD

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  1. Cheng Wang MD
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Correspondence to Dianfu Li MD or Weihua Zhou PhD.

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Cite this article

Wang, C., Ma, Y., Liu, Y. et al. Texture analysis of SPECT myocardial perfusion provides prognostic value for dilated cardiomyopathy. J. Nucl. Cardiol. 30, 504–515 (2023). https://doi.org/10.1007/s12350-022-03006-4

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Keywords

  • Dilated cardiomyopathy
  • Single-photon emission computed tomography
  • Texture analysis
  • Total perfusion deficit

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