A combined model incorporating clinical and CT-based radiomic features predicted peri-device leakage 3 months after left atrial appendage closure with an AUC of 0.796.
Cohort (n=100)
Single-blind
Yes
Does a combined clinical and CT-based radiomic model improve the prediction of peri-device leakage at 3 months after left atrial appendage closure in patients with nonvalvular atrial fibrillation?
A combined prediction model incorporating clinical factors and CT-based radiomics, notably the least axis length of the LAA, effectively predicts peri-device leakage 3 months after LAAC.
Effect estimate: AUC 0.796 (95% CI 0.704-0.888)
Absolute Event Rate: 0.796% vs 0.711%
Peri-device leakage (PDL) is one of the major complications of left atrial appendage closure (LAAC). However, there is a lack of predictive models in clinical practice. The aim of this study was to develop and validate a prediction model for PDLs after LAAC based on preoperative CT and CT-based radiomic features. This retrospective cohort study included 100 patients with nonvalvular atrial fibrillation who underwent LAAC between August 2023 and August 2024 at two centers. A clinical model was constructed via binary logistic regression with clinical information, and a radiomic model was constructed via conventional CT measurements and radiomic features. A combined model was also constructed by combining clinical information and imaging features. The performance of all the models was evaluated and compared, and internal validation was performed via the bootstrap method. Multivariate analysis revealed that the least axis length, larger diameter, and hypertension grade 3 were independent risk factors for PDLs. The combined model constructed based on these three factors (AUC: 0.796, 95% CI: 0.704–0.888) was superior to the clinical model (AUC: 0.711, 95% CI: 0.605–0.817) and the radiomic model (AUC: 0.743, 95% CI: 0.641–0.845). This study is the first to find that the least axis length of the LAA was an independent risk factor for the PDL. The combined model demonstrated a high degree of reliability in predicting the PDL at 3 months following LAAC. This model exhibited a greater predictive capacity than the clinical model and radiomic model did.
Lu et al. (Thu,) conducted a cohort in Nonvalvular atrial fibrillation (n=100). Combined clinical and radiomic prediction model vs. Clinical model was evaluated on Prediction of peri-device leakage (AUC) (AUC 0.796, 95% CI 0.704-0.888). A combined model incorporating clinical and CT-based radiomic features predicted peri-device leakage 3 months after left atrial appendage closure with an AUC of 0.796.