Coronary X-ray angiography is a crucial clinical procedure for the diagnosis and treatment of coronary artery disease, which accounts for roughly 16% of global deaths every year. However, the images acquired in these procedures have low resolution and poor contrast, making lesion detection and assessment challenging. Accurate coronary artery segmentation not only helps mitigate these problems, but also allows the extraction of relevant anatomical features for further analysis by quantitative methods. Although automated segmentation of coronary arteries has been proposed before, previous approaches have used non-optimal segmentation criteria, leading to less useful results. Most methods either segment only the major vessel, discarding important information from the remaining ones, or segment the whole coronary tree based mostly on contrast information, producing a noisy output that includes vessels that are not relevant for diagnosis. We adopt a better-suited clinical criterion and segment vessels according to their clinical relevance. Additionally, we simultaneously perform catheter segmentation, which may be useful for diagnosis due to the scale factor provided by the catheter's known diameter, and is a task that has not yet been performed with good results. To derive the optimal approach, we conducted an extensive comparative study of encoder-decoder architectures trained on a combination of focal loss and a variant of generalized dice loss. Based on the EfficientNet and the UNet++ architectures, we propose a line of efficient and high-performance segmentation models using a new decoder architecture, the EfficientUNet++, whose best-performing version achieved average dice scores of 0.8904 and 0.7526 for the artery and catheter classes, respectively, and an average generalized dice score of 0.9234.
LWT-ARTERY-LABEL: A Lightweight Framework for Automated Coronary Artery Identification
School of Mechanical and Manufacturing Engineering, University of New South Wales（机械与制造工程学院，新南威尔士大学）；School of Computer Science and Engineering, University of New South Wales（计算机科学与工程学院，新南威尔士大学）；Department of Radiology, Prince of Wales Hospital, Sydney, Australia（放射科，威尔士王子医院，悉尼，澳大利亚）；School of Medicine, University of New South Wales（医学院，新南威尔士大学）
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 …
School of Computer Science and Technology, Anhui University（安徽大学计算机科学与技术学院）；National Heart & Lung Institute, Imperial College London（帝国理工学院国家心肺研究所）；Key Laboratory of Intelligent Computing and Signal Processing, Ministry of Education, Anhui University（安徽大学智能计算与信号处理教育部重点实验室）；Cardiovascular Research Centre, Royal Brompton Hospital（皇家布朗普顿医院心血管研究中心）；School of Biomedical Engineering, Sun Yat-Sen University（中山大学生物医学工程学院）；Western University（韦仕敦大学）
The quantification of the coronary artery stenosis is of significant clinical importance in coronary artery disease diagnosis and intervention treatment. It aims to quantify the morphological indices of the coronary artery lesions such as minimum lumen diameter, reference vessel diameter, lesion length, and these indices are the reference of the interventional stent placement. In this study, we propose a direct multiview quantitative coronary angiography (DMQCA) model as an automatic clinical tool to quantify the coronary artery stenosis from X-ray coronary angiography images. The proposed DMQ…
Henan University of Chinese Medicine（河南中医药大学）；Beijing University of Posts and Telecommunications（北京邮电大学）；Institute of Automation, Chinese Academy of Sciences（中国科学院自动化研究所）
In recent years, deep convolution neural networks (DCNNs) have achieved great prospects in coronary artery vessel segmentation. However, it is difficult to deploy complicated models in clinical scenarios since high-performance approaches have excessive parameters and high computation costs. To tackle this problem, we propose \textbf{LightVessel}, a Similarity Knowledge Distillation Framework, for lightweight coronary artery vessel segmentation. Primarily, we propose a Feature-wise Similarity Distillation (FSD) module for semantic-shift modeling. Specifically, we calculate the feature similarit…
3DGR-CAR: Coronary artery reconstruction from ultra-sparse 2D X-ray views with a 3D Gaussians representation
School of Biomedical Engineering, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC)（中国科学技术大学生命科学与医学部生物医学工程学院）；Center for Medical Imaging, Robotics, Analytic Computing & Learning (MIRACLE), Suzhou Institute for Advance Research, USTC（中国科学技术大学苏州研究院医学影像、机器人、分析计算与学习中心）
Instituto Superior Técnico（高等技术学院）；University of Lisbon（里斯本大学）；CCUL（里斯本大学中心学院）；Lisbon School of Medicine（里斯本医学院）
Coronary artery disease leading up to stenosis, the partial or total blocking of coronary arteries, is a severe condition that affects millions of patients each year. Automated identification and classification of stenosis severity from minimally invasive procedures would be of great clinical value, but existing methods do not match the accuracy of experienced cardiologists, due to the complexity of the task. Although a number of computational approaches for quantitative assessment of stenosis have been proposed to date, the performance of these methods is still far from the required levels fo…
Daegu Gyeongbuk Institute of Science & Technology（大邱庆北科学技术院）；Yonsei University College of Medicine（延世大学医学院）
Background and Objective: Incomplete Kawasaki disease (KD) has often been misdiagnosed due to a lack of the clinical manifestations of classic KD. However, it is associated with a markedly higher prevalence of coronary artery lesions. Identifying coronary artery lesions by echocardiography is important for the timely diagnosis of and favorable outcomes in KD. Moreover, similar to KD, coronavirus disease 2019, currently causing a worldwide pandemic, also manifests with fever; therefore, it is crucial at this moment that KD should be distinguished clearly among the febrile diseases in children. …
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…
Learning Hemodynamic Scalar Fields on Coronary Artery Meshes: A Benchmark of Geometric Deep Learning Models
Politecnico di Milano（米兰理工大学）；University of Twente（特文特大学）；Centro Cardiologico Monzino IRCCS（蒙齐诺心脏中心IRCCS）；University of Milan（米兰大学）；Amsterdam UMC（阿姆斯特丹大学医学中心）；University of Amsterdam（阿姆斯特丹大学）
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…
A Deep Learning Model for Coronary Artery Segmentation and Quantitative Stenosis Detection in Angiographic Images
School of Mathematical Sciences, Ocean University of China（中国海洋大学数学科学学院）；School of Haide, Ocean University of China（中国海洋大学海德学院）；School of Ocean and Atmosphere, Ocean University of China（中国海洋大学海洋与大气学院）；Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University（山东大学齐鲁医院（青岛））
Cross-Task Data Augmentation by Pseudo-label Generation for Region Based Coronary Artery Instance Segmentation
Nepal Applied Mathematics and Informatics Institute for research(NAAMII)（尼泊尔应用数学与信息学研究所）；Fogsphere(Redev AI Ltd.)（Fogsphere（Redev AI有限公司））；University of Lausanne（洛桑大学）；School of Natural and Computing Sciences, University of Aberdeen（阿伯丁大学自然与计算科学学院）
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…
Shanghai Jiao Tong University（上海交通大学）；Peking Union Medical College Hospital（北京协和医院）
The segmentation of coronary arteries by convolutional neural network is promising yet requires a large amount of labor-intensive manual annotations. Transferring knowledge from retinal vessels in widely-available public labeled fundus images (FIs) has a potential to reduce the annotation requirement for coronary artery segmentation in X-ray angiograms (XAs) due to their common tubular structures. However, it is challenged by the cross-anatomy domain shift due to the intrinsically different vesselness characteristics in different anatomical regions under even different imaging protocols. To so…
ImageCAS: A Large-Scale Dataset and Benchmark for Coronary Artery Segmentation based on Computed Tomography Angiography Images
Guangdong University of Technology（广东工业大学）；Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences)（广东省人民医院（广东省医学科学院））；Southern Medical University（南方医科大学）；Missouri University of Science and Technology（密苏里科技大学）
X-ray coronary angiography (XCA) is a principal approach employed for identifying coronary disorders. Deep learning-based networks have recently shown tremendous promise in the diagnosis of coronary disorder from XCA scans. A deep learning-based edge adaptive instance normalization style transfer technique for segmenting the coronary arteries, is presented in this paper. The proposed technique combines adaptive instance normalization style transfer with the dense extreme inception network and convolution block attention module to get the best artery segmentation performance. We tested the prop…
A topology-preserving three-stage framework for fully-connected coronary artery extraction
Center for Digital Media Computing, School of Film, School of Informatics, Xiamen University（厦门大学电影学院、信息学院数字媒体计算中心）；Institute of Artificial Intelligence, Xiamen University（厦门大学人工智能研究院）；Peking Union Medical College Hospital（北京协和医院）；Shanghai United Imaging Intelligence Co., Ltd.（上海联影智能医疗科技有限公司）；City University of Hong Kong（香港城市大学）；Shanghai Clinical Research and Trial Center（上海临床研究与试验中心）
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）
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）
CADICA: a new dataset for coronary artery disease detection by using invasive coronary angiography
University of Málaga（马拉加大学）；Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND（马拉加生物医学与纳米医学平台研究所-IBIMA BIONAND平台）；Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV)（心血管疾病网络生物医学研究中心）；Instituto de Salud Carlos III (ISCIII)（卡洛斯三世卫生研究所）
Bioinformatics Institute, Agency for Science, Technology and Research (A*STAR)（新加坡科技研究局生物信息学研究所）；Hwa Chong Institution (College)（华侨中学（高中部））；National Heart Centre Singapore（新加坡国家心脏中心）；Duke-NUS Medical School（杜克-新加坡国立大学医学院）；School of Computing, National University of Singapore（新加坡国立大学计算学院）；Singapore Eye Research Institute (SERI)（新加坡眼科研究所）；Rehabilitation Research Institute of Singapore（新加坡康复研究所）；Institute of Bioengineering and Nanotechnology, A*STAR（新加坡科技研究局生物工程与纳米技术研究所）
The evaluation of obstructions (stenosis) in coronary arteries is currently done by a physician's visual assessment of coronary angiography video sequences. It is laborious, and can be susceptible to interobserver variation. Prior studies have attempted to automate this process, but few have demonstrated an integrated suite of algorithms for the end-to-end analysis of angiograms. We report an automated analysis pipeline based on deep learning to rapidly and objectively assess coronary angiograms, highlight coronary vessels of interest, and quantify potential stenosis. We propose a 3-stage auto…
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…
To decrease patient waiting time for diagnosis of the Coronary Artery Disease, automatic methods are applied to identify its severity using Coronary Computed Tomography Angiography scans or extracted Multiplanar Reconstruction (MPR) images, giving doctors a second-opinion on the priority of each case. The main disadvantage of previous studies is the lack of large set of data that could guarantee their reliability. Another limitation is the usage of handcrafted features requiring manual preprocessing, such as centerline extraction. We overcome both limitations by applying a different automated …
Coronary heart disease (CHD) is the leading cause of adult death in the United States and worldwide, and for which the coronary angiography procedure is the primary gateway for diagnosis and clinical management decisions. The standard-of-care for interpretation of coronary angiograms depends upon ad-hoc visual assessment by the physician operator. However, ad-hoc visual interpretation of angiograms is poorly reproducible, highly variable and bias prone. Here we show for the first time that fully-automated angiogram interpretation to estimate coronary artery stenosis is possible using a sequenc…
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 …
Guangdong Cardiovascular Institute（广东省心血管病研究所）；Guangdong Provincial People’s Hospital（广东省人民医院）；Guangdong Academy of Medical Sciences（广东省医学科学院）；University of Notre Dame（圣母大学）
Coronary artery disease (CAD) is the most common cause of death globally, and its diagnosis is usually based on manual myocardial segmentation of Magnetic Resonance Imaging (MRI) sequences. As the manual segmentation is tedious, time-consuming and with low applicability, automatic myocardial segmentation using machine learning techniques has been widely explored recently. However, almost all the existing methods treat the input MRI sequences independently, which fails to capture the temporal information between sequences, e.g., the shape and location information of the myocardium in sequences …
Unleashing Vision Foundation Models for Coronary Artery Segmentation: Parallel ViT-CNN Encoding and Variational Fusion
National-Local Joint Engineering Research Center of Biodiagnosis \& Biotherapy, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710004, China Institute of Medical Artificial Intelligence, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi'an, 710004, China Viadrina European University, Frankfurt (Oder), 15230, Germany
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…
The University of Alabama at Birmingham（阿拉巴马大学伯明翰分校）；The Icahn School of Medicine at Mount Sinai（西奈山伊坎医学院）
Histopathological analysis is crucial in artery characterization for coronary artery disease (CAD). However, histology requires an invasive and time-consuming process. In this paper, we propose to generate virtual histology staining using Optical Coherence Tomography (OCT) images to enable real-time histological visualization. We develop a deep learning network, namely Coronary-GAN, to transfer coronary OCT images to virtual histology images. With a special consideration on the structural constraints in coronary OCT images, our method achieves better image generation performance than the conve…
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…
Automatic extraction of coronary arteries using deep learning in invasive coronary angiograms
Zhengzhou University of Light Industry（郑州轻工业大学）；Michigan Technological University（密歇根理工大学）；The First Affiliated Hospital of Nanjing Medical University（南京医科大学第一附属医院）
Friedrich-Alexander-University Erlangen-Nuremberg（埃尔朗根-纽伦堡弗里德里希-亚历山大大学）；Siemens Healthineers（西门子医疗）；University Clinic Frankfurt（法兰克福大学诊所）；Cardioangiological Centrum Bethanien（贝塔宁心血管中心）
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 a…
In recent years, coronary artery disease is escalating and is likely to assume an epidemic proportion by 2030. Currently the reliable methods for detection of coronary arterial lesions are either conventional coronary angiogram (CAG) or MDCT (Multiple Detector Computed Tomography) coronary angiogram. Conventional CAG is an invasive procedure. Conventional CAG and CT (Computed Tomography) angiogram, both require expert supervision of either an interventional cardiologist or a radiologist. In this work, we have proposed a novel design and method for non-invasive detection and localization of cor…
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 …
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）
Coronary angiography is the "gold standard" for diagnosing coronary artery disease (CAD). At present, the methods for detecting and evaluating coronary artery stenosis cannot satisfy the clinical needs, e.g., there is no prior study of detecting stenoses in prespecified vessel segments, which is necessary in clinical practice. Two vascular stenosis detection methods are proposed to assist the diagnosis. The first one is an automatic method, which can automatically extract the entire coronary artery tree and mark all the possible stenoses. The second one is an interactive method. With this meth…
Hankuk University of Foreign Studies（韩国外国语大学）；Seoul National University Bundang Hospital（首尔大学盆唐医院）
The Coronary Artery Occlusion (CAO) acutely comes to human, and it highly threats the human's life. When CAO detected, Percutaneous Coronary Intervention (PCI) should be conducted timely. Before PCI, localizing the CAO is needed firstly, because the heart is covered with various arteries. We handle the three kinds of CAO in this paper and our purpose is not only localization of CAO but also improving the localizing performance via preprocessing method. We improve localization performance from a minimum of 0.150 to a maximum of 0.372 via our noise reduction and pulse extraction based method.
University of Birjand（比尔詹德大学）；Deakin University（迪肯大学）；Iran University of Medical Sciences（伊朗医科大学）；Omid hospital（奥米德医院）；Maragheh Faculty of Medical Sciences（马拉盖医学院）；Universiti Kebangsaan Malaysia（马来西亚国民大学）
Cardiovascular disease is one of the most challenging diseases in middle-aged and older people, which causes high mortality. Coronary artery disease (CAD) is known as a common cardiovascular disease. A standard clinical tool for diagnosing CAD is angiography. The main challenges are dangerous side effects and high angiography costs. Today, the development of artificial intelligence-based methods is a valuable achievement for diagnosing disease. Hence, in this paper, artificial intelligence methods such as neural network (NN), deep neural network (DNN), and Fuzzy C-Means clustering combined wit…
