Automated Classification of Atherosclerotic Radiomics Features in Coronary Computed Tomography Angiography (CCTA)

Radiomics is the process of extracting useful quantitative features of high-dimensional data that allows for automated disease classification, including atherosclerotic disease. Hence, this study aimed to quantify and extract the radiomic features from Coronary Computed Tomography Angiography (CCTA) images and to evaluate the performance of automated machine learning (AutoML) model in classifying the atherosclerotic plaques. In total, 202 patients who underwent CCTA examination at Institut Jantung Negara (IJN) between September 2020 and May 2021 were selected as they met the inclusion criteria. Three primary coronary arteries were segmented on axial sectional images, yielding a total of 606 volume of interest (VOI). Subsequently, the first order, second order, and shape order of radiomic characteristics were extracted for each VOI. Model 1, Model 2, Model 3, and Model 4 were constructed using AutoML-based Tree-Pipeline Optimization Tools (TPOT). The heatmap confusion matrix, recall (sensitivity), precision (PPV), F1 score, accuracy, receiver operating characteristic (ROC), and area under the curve (AUC) were analysed. Notably, Model 1 with the first-order features showed superior performance in classifying the normal coronary arteries (F1 score: 0.88; Inverse F1 score: 0.94), as well as in classifying the calcified (F1 score: 0.78; Inverse F1 score: 0.91) and mixed plaques (F1 score: 0.76; Inverse F1 score: 0.86). Moreover, Model 2 consisting of second-order features was proved useful, specifically in classifying the non-calcified plaques (F1 score: 0.63; Inverse F1 score: 0.92) which are a key point for prediction of cardiac events. Nevertheless, Model 3 comprising the shape-based features did not contribute to the classification of atherosclerotic plaques. Overall, TPOT shown promising capabilities in terms of finding the best pipeline and tailoring the model using CCTA-based radiomic datasets.