Analysing coronary artery plaque segments with respect to their functional significance and therefore their influence to patient management in a non-invasive setup is an important subject of current research. In this work we compare and improve three deep learning algorithms for this task: A 3D recurrent convolutional neural network (RCNN), a 2D multi-view ensemble approach based on texture analysis, and a newly proposed 2.5D approach. Current state of the art methods utilising fluid dynamics based fractional flow reserve (FFR) simulation reach an AUC of up to 0.93 for the task of predicting an abnormal invasive FFR value. For the comparable task of predicting revascularisation decision, we are able to improve the performance in terms of AUC of both existing approaches with the proposed modifications, specifically from 0.80 to 0.90 for the 3D-RCNN, and from 0.85 to 0.90 for the multi-view texture-based ensemble. The newly proposed 2.5D approach achieves comparable results with an AUC of 0.90.
The University of Tokyo（东京大学）；RIKEN Center for Advanced Intelligence Project（理化学研究所先进智能项目中心）；Sakurabashi Watanabe Hospital（樱桥渡边医院）
Providing closed and well-connected boundaries of coronary artery is essential to assist cardiologists in the diagnosis of coronary artery disease (CAD). Recently, several deep learning-based methods have been proposed for boundary detection and segmentation in a medical image. However, when applied to coronary wall detection, they tend to produce disconnected and inaccurate boundaries. In this paper, we propose a novel boundary detection method for coronary arteries that focuses on the continuity and connectivity of the boundaries. In order to model the spatial continuity of consecutive image…
O2CTA: Introducing Annotations from OCT to CCTA in Coronary Plaque Analysis
Dushu Lake Hospital Affiliated to Soochow University（苏州大学附属独墅湖医院）；Institution for Hypertension of Soochow University（苏州大学高血压研究所）；University of Science and Technology of China（中国科学技术大学）
Philips Medical Systems Technologies Ltd.（飞利浦医疗系统技术有限公司）
Purpose: The goal of this study was to assess the potential added benefit of accounting for partial volume effects (PVE) in an automatic coronary lumen segmentation algorithm from coronary computed tomography angiography (CCTA). Materials and methods: We assessed the potential added value of PVE integration as a part of the automatic coronary lumen segmentation algorithm by means of segmentation accuracy using the MICCAI 2012 challenge framework and by means of flow simulation overall accuracy, sensitivity, specificity, negative and positive predictive values and the receiver operated characte…
Friedrich-Alexander-Universität Erlangen-Nürnberg（埃尔朗根-纽伦堡弗里德里希-亚历山大大学）；Siemens Healthcare GmbH（西门子医疗有限公司）；University Clinic Frankfurt（法兰克福大学诊所）；Cardioangiological Centrum Bethanien（贝塔尼恩心血管中心）
Assessing coronary artery plaque segments in coronary CT angiography scans is an important task to improve patient management and clinical outcomes, as it can help to decide whether invasive investigation and treatment are necessary. In this work, we present three machine learning approaches capable of performing this task. The first approach is based on radiomics, where a plaque segmentation is used to calculate various shape-, intensity- and texture-based features under different image transformations. A second approach is based on deep learning and relies on centerline extraction as sole pr…
Coronary artery disease (CAD) has posed a leading threat to the lives of cardiovascular disease patients worldwide for a long time. Therefore, automated diagnosis of CAD has indispensable significance in clinical medicine. However, the complexity of coronary artery plaques that cause CAD makes the automatic detection of coronary artery stenosis in Coronary CT angiography (CCTA) a difficult task. In this paper, we propose a Transformer network (TR-Net) for the automatic detection of significant stenosis (i.e. luminal narrowing > 50%) while practically completing the computer-assisted diagnosis …
Mayo Clinic（梅奥诊所）；University of Iowa（爱荷华大学）；Siemens Healthineers（西门子医疗）；NVIDIA（英伟达）
Coronary Computed Tomography Angiography (CCTA) evaluation of chest-pain patients in an Emergency Department (ED) is considered appropriate. While a negative CCTA interpretation supports direct patient discharge from an ED, labor-intensive analyses are required, with accuracy in jeopardy from distractions. We describe the development of an Artificial Intelligence (AI) algorithm and workflow for assisting interpreting physicians in CCTA screening for the absence of coronary atherosclerosis. The two-phase approach consisted of (1) Phase 1 - focused on the development and preliminary testing of a…
Universität Erlangen-Nürnberg（埃尔朗根-纽伦堡大学）；Siemens Healthcare GmbH（西门子医疗有限公司）；Das Radiologische Zentrum - Radiology Center（放射中心）
Coronary CT angiography (CCTA) has established its role as a non-invasive modality for the diagnosis of coronary artery disease (CAD). The CAD-Reporting and Data System (CAD-RADS) has been developed to standardize communication and aid in decision making based on CCTA findings. The CAD-RADS score is determined by manual assessment of all coronary vessels and the grading of lesions within the coronary artery tree. We propose a bottom-up approach for fully-automated prediction of this score using deep-learning operating on a segment-wise representation of the coronary arteries. The method relies…
The Ohio State University College of Medicine（俄亥俄州立大学医学院）
We propose a fully automated algorithm based on a deep learning framework enabling screening of a coronary computed tomography angiography (CCTA) examination for confident detection of the presence or absence of coronary artery atherosclerosis. The system starts with extracting the coronary arteries and their branches from CCTA datasets and representing them with multi-planar reformatted volumes; pre-processing and augmentation techniques are then applied to increase the robustness and generalization ability of the system. A 3-dimensional convolutional neural network (3D-CNN) is utilized to mo…
Image Sciences Institute, University Medical Center Utrecht（乌得勒支大学医学中心影像科学研究所）；University Medical Center Utrecht（乌得勒支大学医学中心）；Utrecht University（乌得勒支大学）；Amsterdam University Medical Center（阿姆斯特丹大学医学中心）
Treatment of patients with obstructive coronary artery disease is guided by the functional significance of a coronary artery stenosis. Fractional flow reserve (FFR), measured during invasive coronary angiography (ICA), is considered the gold standard to define the functional significance of a coronary stenosis. Here, we present a method for non-invasive detection of patients with functionally significant coronary artery stenosis, combining analysis of the coronary artery tree and the left ventricular (LV) myocardium in cardiac CT angiography (CCTA) images. We retrospectively collected CCTA sca…
CAD-RADS scoring of coronary CT angiography with Multi-Axis Vision Transformer: a clinically-inspired deep learning pipeline
University of Pavia（帕维亚大学）；Centro Cardiologico Monzino IRCCS（蒙齐诺心脏病学中心IRCCS）；University of Milan（米兰大学）；IRCCS Istituti Clinici Scientifici Maugeri（IRCCS莫杰里科学临床研究所）
Image Sciences Institute, University Medical Center Utrecht（乌得勒支大学医学中心影像科学研究所）；University Medical Center Utrecht（乌得勒支大学医学中心）；Amsterdam University Medical Center（阿姆斯特丹大学医学中心）；Utrecht University（乌得勒支大学）
In patients with obstructive coronary artery disease, the functional significance of a coronary artery stenosis needs to be determined to guide treatment. This is typically established through fractional flow reserve (FFR) measurement, performed during invasive coronary angiography (ICA). We present a method for automatic and non-invasive detection of patients requiring ICA, employing deep unsupervised analysis of complete coronary arteries in cardiac CT angiography (CCTA) images. We retrospectively collected CCTA scans of 187 patients, 137 of them underwent invasive FFR measurement in 192 dif…
TG-OT: Topology-guided CCTA-IVUS registration via optimal transport matching
Weill Cornell Medicine（威尔康奈尔医学院）；Cornell Tech（康奈尔科技校区）；Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam（阿姆斯特丹大学医学中心生物医学工程与物理系）；Amsterdam Cardiovascular Sciences（阿姆斯特丹心血管科学研究中心）；Department of Radiology, Mayo Clinic（梅奥诊所放射学系）；Department of Cardiology, Erasmus University Medical Center（伊拉斯姆斯大学医学中心心脏病学系）
DeepCA: Deep Learning-based 3D Coronary Artery Tree Reconstruction from Two 2D Non-simultaneous X-ray Angiography Projections
University of Oxford（牛津大学）；Institute of Biomedical Engineering（生物医学工程研究所）；Division of Cardiovascular Medicine（心血管医学部）；Radcliffe Department of Medicine（拉德克利夫医学系）；Oxford Acute Vascular Imaging Centre（牛津急性血管成像中心）
An Intra- and Cross-frame Topological Consistency Scheme for Semi-supervised Atherosclerotic Coronary Plaque Segmentation
Xiamen University（厦门大学）；University of Washington（华盛顿大学）；Institute of Artificial Intelligence, Xiamen University（厦门大学人工智能研究院）；National Institute for Data Science in Health and Medicine, Xiamen University（厦门大学健康与医学数据科学国家研究院）
The purpose of this study is to present a new semi-automated methodology for three-dimensional (3D) reconstruction of coronary arteries and their plaque morphology using Computed Tomography Angiography (CTA) images. The methodology is summarized in seven stages: pre-processing of the acquired CTA images, extraction of the vessel tree centerline, estimation of a weight function for lumen, outer wall and calcified plaque, lumen segmentation, outer wall segmentation, plaque detection, and finally 3D surfaces construction. The methodology was evaluated using both expert manual annotations and esti…
Federated Learning for Coronary Artery Plaque Detection in Atherosclerosis Using IVUS Imaging: A Multi-Hospital Collaboration
Research Center for Information Technology Innovation, Academia Sinica（中央研究院资讯科技创新研究中心）；National Taiwan University（台湾大学）；Taipei Veterans General Hospital（台北荣民总医院）；National Yang Ming Chiao Tung University（阳明交通大学）
Image Sciences Institute（影像科学研究所）；University Medical Center Utrecht（乌得勒支大学医学中心）；Department of Radiology（放射科）
Detection of coronary artery stenosis in coronary CT angiography (CCTA) requires highly personalized surface meshes enclosing the coronary lumen. In this work, we propose to use graph convolutional networks (GCNs) to predict the spatial location of vertices in a tubular surface mesh that segments the coronary artery lumen. Predictions for individual vertex locations are based on local image features as well as on features of neighboring vertices in the mesh graph. The method was trained and evaluated using the publicly available Coronary Artery Stenoses Detection and Quantification Evaluation …
Case Western Reserve University（凯斯西储大学）；The Hashemite University（哈希姆大学）；University Hospitals Cleveland Medical Center（克利夫兰大学医院医学中心）；Florida Institute of Technology（佛罗里达理工学院）；University of South Florida（南佛罗里达大学）
BACKGROUND Careful evaluation of the risk of stent under-expansions before the intervention will aid treatment planning, including the application of a pre-stent plaque modification strategy. OBJECTIVES It remains challenging to achieve a proper stent expansion in the presence of severely calcified coronary lesions. Building on our work in deep learning segmentation, we created an automated machine learning approach that uses lesion attributes to predict stent under-expansion from pre-stent images, suggesting the need for plaque modification. METHODS Pre- and post-stent intravascular optical c…
University of Amsterdam（阿姆斯特丹大学）；University Medical Center Utrecht（乌得勒支大学医学中心）
Deep learning-based whole-heart segmentation in coronary CT angiography (CCTA) allows the extraction of quantitative imaging measures for cardiovascular risk prediction. Automatic extraction of these measures in patients undergoing only non-contrast-enhanced CT (NCCT) scanning would be valuable. In this work, we leverage information provided by a dual-layer detector CT scanner to obtain a reference standard in virtual non-contrast (VNC) CT images mimicking NCCT images, and train a 3D convolutional neural network (CNN) for the segmentation of VNC as well as NCCT images. Contrast-enhanced acquis…
Tsinghua University（清华大学）；Beijing Anzhen Hospital, Capital Medical University（首都医科大学附属北京安贞医院）；The First Affiliated Hospital of Zhengzhou University（郑州大学第一附属医院）
Coronary angiography is an indispensable assistive technique for cardiac interventional surgery. Segmentation and extraction of blood vessels from coronary angiography videos are very essential prerequisites for physicians to locate, assess and diagnose the plaques and stenosis in blood vessels. This article proposes a new video segmentation framework that can extract the clearest and most comprehensive coronary angiography images from a video sequence, thereby helping physicians to better observe the condition of blood vessels. This framework combines a 3D convolutional layer to extract spati…
Friedrich-Alexander-Universität Erlangen-Nürnberg（埃尔朗根-纽伦堡弗里德里希-亚历山大大学）；Siemens Healthcare GmbH（西门子医疗有限公司）；Das Radiologische Zentrum - Radiology Center（放射学中心）
With coronary artery disease (CAD) persisting to be one of the leading causes of death worldwide, interest in supporting physicians with algorithms to speed up and improve diagnosis is high. In clinical practice, the severeness of CAD is often assessed with a coronary CT angiography (CCTA) scan and manually graded with the CAD-Reporting and Data System (CAD-RADS) score. The clinical questions this score assesses are whether patients have CAD or not (rule-out) and whether they have severe CAD or not (hold-out). In this work, we reach new state-of-the-art performance for automatic CAD-RADS scori…
Vessel stenosis is a major risk factor in cardiovascular diseases (CVD). To analyze the degree of vessel stenosis for supporting the treatment management, extraction of coronary artery area from Computed Tomographic Angiography (CTA) is regarded as a key procedure. However, manual segmentation by cardiologists may be a time-consuming task, and present a significant inter-observer variation. Although various computer-aided approaches have been developed to support segmentation of coronary arteries in CTA, the results remain unreliable due to complex attenuation appearance of plaques, which are …
Multivessel Coronary Artery Segmentation and Stenosis Localisation using Ensemble Learning
Birmingham City University（伯明翰城市大学）；University of the West of England (UWE)（西英格兰大学）；Institute of Accounting and Administration, University of Aveiro（阿威罗大学会计与行政学院）；NUS High School of Math and Science（新加坡国立大学数学与科学高中）；Qatar University（卡塔尔大学）；Information Technology University（信息技术大学）；Bristol Heart Institute, University of Bristol（布里斯托大学布里斯托心脏研究所）
