Next, the researchers used the patients’ MRIs to create scarred tissue maps, extracting a comprehensive set of radiomic features including 14 shape parameters and 930 texture features, leading to 1,888 radiomic features representing the shape and texture of each patient’s scar tissue map. From these data, the team developed new mathematical models for predicting the probability of sudden cardiac death.

When the scientists looked at the patients’ outcomes, they saw that 30 patients (or 2.4 percent) experienced a sudden cardiac death event within a follow-up period of up to 6.5 years. Integrating radiomic features with the clinical risk assessment scores significantly improved risk prediction, with one model accurately flagging 19 of the patients who experienced a sudden cardiac death event as high-risk.


Moreover, the analysis revealed one radiomic feature with significant prognostic value for predicting sudden cardiac death risk – a texture feature of the scar tissue map. While further investigation is needed, the finding demonstrates how radiomics may help reveal new biomarkers that may be useful for monitoring patients with HCM and other conditions with few clinical signs and symptoms.

“Advances in imaging technologies and image analysis tools have allowed the investigation of novel features to predict the risk of sudden cardiac death in patients with HCM,” said Martin Maron, MD, Director of the Hypertrophic Cardiomyopathy Center at LHMC. “Our proof-of-concept study showed that radiomics analysis can add incremental prognostic value to current established risk prediction models, potentially saving lives.”

Co-authors included Narjes Jaafar, MD, Jennifer Rodriguez, BS, Shiro Nakamori, MD, and Long H. Ngo, PhD, of BIDMC; Ethan J. Rowin, MD, and Martin Maron, MD, of Lahey Hospital and Medical Center; Raymond H. Chan, MD, of Toronto General Hospital; Silvia Pradella, MD, PhD, and Iacopo Olivotto, MD, of Hospital Careggi; Chiara Zocchi, MD, of San Donato Hospital.

This work was supported in part by the National Institutes of Health (grants 1R01HL29185, 1R01HL129157, 1R01HL127015, R01HL158098, and R01HL154744).

The authors declare no conflicts of interest related to this study. Nezafat has a research agreement with Siemens Healthineers, the manufacturer of MRI systems. Fahmy is currently affiliated with Novo Nordisk Research Center, Seattle, WA.


About Beth Israel Deaconess Medical Center
Beth Israel Deaconess Medical Center is a patient care, teaching and research affiliate of Harvard Medical School and consistently ranks as a national leader among independent hospitals in National Institutes of Health funding. BIDMC is the official hospital of the Boston Red Sox.

Beth Israel Deaconess Medical Center is a part of Beth Israel Lahey Health, a health care system that brings together academic medical centers and teaching hospitals, community and specialty hospitals, more than 4,800 physicians and 36,000 employees in a shared mission to expand access to great care and advance the science and practice of medicine through groundbreaking research and education.

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