Cine MRI-Derived Radiomics for the Detection of Functional Tricuspid Regurgitation in Pulmonary Hypertension: A Proof-of-Concept Study

(1) Objective: The objective was to test the hypothesis that cine MRI-derived radiomic features can detect functional tricuspid regurgitation (FTR) in the context of pulmonary hypertension (PH). (2) Materials and methods: In total, 53 PH patients were retrospectively enrolled. Thirty-three patients had echocardiography-defined mild-to-severe FTR, while the other twenty patients had no or trivial regurgitation. For all participants, 93 radiomic features were extracted from four-chamber cine MRI using a fixed-size region of interest (ROI) located in the right atrium (RA), 0.5-1 cm above the tricuspid valve. The levels of radiomic features were averaged over the ventricular systole and compared between patients with and without FTR using t tests. In patients with FTR, radiomic features were related to hemodynamic parameters in the right heart using the Pearson correlation coefficient (r). (3) Results: There were no significant differences in demographic information, right heart catheterization (RHC) results, and most cine MRI-derived cardiac function indices between the two subject groups. Eight of ninety-three radiomic features were significantly different between PH patients with and without FTR. Radiomic features can be used to discriminate two subject groups (AUC = 0.77). In patients with FTR, multiple radiomic features are related to the pressure in the RA, right ventricle (RV), and pressure difference between RA and RV (r: 0.4 to 0.55), <i>p</i> values < 0.05. (4) Conclusion: Cine MRI-derived radiomic features of the cardiac blood pool differ between PH patients with and without FTR. Cine MRI shows promise as a method for assessing FTR in the context of complex cardiovascular diseases (CVDs).