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nnU-Net-based whole-coronary pericoronary adipose tissue radiomics combined with clinical factors for predicting coronary plaque development in individuals with normal coronary arteries

Year: 2026

Type: article

Abstract: Effective early prediction of coronary artery disease remains challenging. This study aims to investigate whether radiomic features of pericoronary adipose tissue (PCAT) derived from the whole-coronary tree using nnU-Net, combined with PCAT metrics and clinical factors, can predict coronary plaque development during follow-up in individuals with normal baseline coronary arteries. In this retrospective study, 210 patients with normal baseline coronary CT angiography (CCTA) findings who underwent follow-up CCTA were included and classified into plaque-positive and plaque-negative groups. Baseline clinical data and PCAT metrics (fat attenuation index [FAI] and fat volume [FV]) were collected. Radiomic features were extracted from whole-coronary PCAT based on nnU-Net. Patients were randomly divided into training and validation sets (7:3). Five logistic regression models (clinical, PCAT, clinical–PCAT, radiomics, and combined) were constructed and compared using receiver operating characteristic analysis, calibration curves, and decision curve analysis. During follow-up, 77 of 210 patients (36.7%) developed coronary plaques. One clinical factor, three PCAT metrics, and 20 radiomic features were selected. The combined model demonstrated the best performance, with training/validation set AUC values of 0.931 (95% CI 0.889–0.973) and 0.896 (95% CI 0.821–0.970). Calibration and decision curve analyses demonstrated good agreement and clinical utility. An automated nnU-Net-based whole-coronary PCAT radiomics model, integrated with clinical factors, demonstrates potential for early risk stratification of plaque development in individuals with normal coronary arteries.

Source: European journal of medical research

DOI: 10.1186/s40001-026-04772-4

Authors: Chao Wang, Bingbing Zhang, Chang Rong, Xiaomin Zheng, Yichao Liu, Xingwang Wu

Institutions: Bozhou People's Hospital, First Affiliated Hospital of Anhui Medical University

Language: English

Topic: Cardiovascular Disease and Adiposity

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,190