Kardiale Radiomics Analysen in Zeiten von Photon-Counting Computertomographen zur personalisierten Risikostratifizierung in der Gegenwart und in der Zukunft

Zusammenfassung

Hintergrund

Die Notwendigkeit einer effektiven Früherkennung und eines optimalen Therapiemonitorings kardiovaskulärer Erkrankungen als häufigste Todesursache hat zu einer Anpassung der Leitlinien mit Fokussierung auf die kardiale Computertomografie (CCTA) bei Patienten mit einem niedrigen bis intermediären Risiko für eine koronare Herzkrankheit (KHK) geführt. Insbesondere die Einführung von Photon-Counting-Computertomografen (PCCT) in der CT-Diagnostik verspricht erhebliche Fortschritte durch eine höhere zeitliche und räumliche Auflösung und ermöglicht auch fortgeschrittene Texturanalysen, bekannt als Radiomics-Analysen. Ursprünglich in der onkologischen Bildgebung entwickelt, finden Radiomics-Analysen zunehmend Anwendung in der kardialen Bildgebung und Forschung. Ziel ist es, sog. Imaging-Biomarker zu generieren, die die Früherkennung kardiovaskulärer Erkrankungen und das Therapiemonitoring verbessern.

Methode

Die vorliegende Studie fasst die aktuellen Entwicklungen in der kardialen CT-Texturanalyse mit besonderer Fokussierung auf Auswertungen an PCCT-Datensätzen an unterschiedlichen Regionen, u.a. dem Myokard, koronarer Plaques und des perikoronaren/epikardialen Fettgewebes zusammen.

Schlussfolgerung

Diese Entwicklungen könnten die Diagnostik und Behandlung von Herz-Kreislauf-Erkrankungen revolutionieren und die Prognosen für Patienten weltweit erheblich verbessern. Ziel dieses Übersichtsartikels ist es, den aktuellen Stand der Radiomics-Forschung in der kardiovaskulären Bildgebung zu beleuchten und Möglichkeiten der Etablierung in der klinischen Routine in Zukunft aufzuzeigen.

Kernaussagen

• Radiomics: Ermöglicht tiefere, objektive Analysen kardiovaskulärer Strukturen durch Merkmalsextraktion.

• PCCT: Bietet höhere Bildqualität, verbessert Stabilität und Reproduzierbarkeit in der kardialen CT.

• Früherkennung: PCCT und Radiomics verbessern Erkennung und Management von Herz-Kreislauf-Erkrankungen.

• Herausforderungen: Technische und Standardisierungsprobleme erschweren die klinische Anwendung.

• Zukunft: Fortschritte bei PCCT-Technologien könnten Radiomics bald in die Routine integrieren.

Zitierweise

• Ayx I, Bauer R, Schönberg SO et al. Cardiac Radiomics Analyses in Times of Photon-counting Computed Tomography for Personalized Risk Stratification in the Present and in the Future. Rofo 2025; DOI 10.1055/a-2499-3122

Publication History

Received: 19 August 2024

Accepted after revision: 04 December 2024

Article published online:
23 January 2025

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