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 of CAD. The proposed TR-Net introduces a novel Transformer, and tightly combines convolutional layers and Transformer encoders, allowing their advantages to be demonstrated in the task. By analyzing semantic information sequences, TR-Net can fully understand the relationship between image information in each position of a multiplanar reformatted (MPR) image, and accurately detect significant stenosis based on both local and global information. We evaluate our TR-Net on a dataset of 76 patients from different patients annotated by experienced radiologists. Experimental results illustrate that our TR-Net has achieved better results in ACC (0.92), Spec (0.96), PPV (0.84), F1 (0.79) and MCC (0.74) indicators compared with the state-of-the-art methods. The source code is publicly available from the link (https://github.com/XinghuaMa/TR-Net).
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…
Michigan Technological University（密歇根理工大学）；University of Southern Mississippi（南密西西比大学）；Tulane University（杜兰大学）；Ochsner Medical Center（奥克斯纳医疗中心）
In stable coronary artery disease (CAD), reduction in mortality and/or myocardial infarction with revascularization over medical therapy has not been reliably achieved. Coronary arteries are usually extracted to perform stenosis detection. We aim to develop an automatic algorithm by deep learning to extract coronary arteries from ICAs.In this study, a multi-input and multi-scale (MIMS) U-Net with a two-stage recurrent training strategy was proposed for the automatic vessel segmentation. Incorporating features such as the Inception residual module with depth-wise separable convolutional layers,…
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…
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…
Babol Noshirvani University of Technology（巴博勒努希尔瓦尼技术大学）；Italian Institute of Technology（意大利技术研究院）；Royan Institute for Stem Cell Biology and Technology（罗扬干细胞生物学与技术研究所）；Sharif University of Technology（谢里夫理工大学）
Prediction of the blood flow characteristics is of utmost importance for understanding the behavior of the blood arterial network, especially in the presence of vascular diseases such as stenosis. Computational fluid dynamics (CFD) has provided a powerful and efficient tool to determine these characteristics including the pressure and velocity fields within the network. Despite numerous studies in the field, the extremely high computational cost of CFD has led the researchers to develop new platforms including Machine Learning approaches that instead provide faster analyses at a much lower cos…
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）
U. of South Carolina（南卡罗来纳大学）；Zucker School of Medicine（扎克医学院）
We report an object tracking algorithm that combines geometrical constraints, thresholding, and motion detection for tracking of the descending aorta and the network of major arteries that branch from the aorta including the iliac and femoral arteries. Using our automated identification and analysis, arterial system was identified with more than 85% success when compared to human annotation. Furthermore, the reported automated system is capable of producing a stenosis profile, and a calcification score similar to the Agatston score. The use of stenosis and calcification profiles will lead to t…
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））
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…
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…
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 …
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…
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…
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）
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…
Background. Percutaneous coronary intervention(PCI) in stable coronary artery disease(CAD) is commonly triggered by abnormal myocardial perfusion imaging(MPI). However, due to the possibilities of multivessel disease and variability of coronary artery perfusion distribution, opportunity exists to better align anatomic stenosis with perfusion abnormalities to improve revascularization decisions. This study aims to develop a 3D multi-modality fusion approach to assist decision-making for PCI. Methods. Coronary arteries from fluoroscopic angiography(FA) were reconstructed into 3D artery anatomy. …
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 …
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…
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）
