Photon-counting CT radiomics of epicardial fat shows modest ability to classify hypertension

Logistic regression using radiomic features of epicardial adipose tissue on photon-counting CT achieved only moderate AUCs of 0.65 (cross-validation) and 0.59 (held-out test) for classifying arterial hypertension. Lower mean EAT attenuation was the most robust finding.

• In 114 patients without coronary artery disease, logistic regression was the best model among three tested.
• The most robust quantitative finding was lower mean epicardial adipose tissue attenuation in the hypertension group.
• These exploratory, single-center results are hypothesis-generating and require validation in larger cohorts.

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