CT-based radiomics to predict peri-device leakage after left atrial appendage closure.

BACKGROUND

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.