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Zhang J, Han R, Shao G, Lv B, Sun K. Artificial Intelligence in Cardiovascular Atherosclerosis Imaging. J Pers Med 2022; 12:jpm12030420. [PMID: 35330420 PMCID: PMC8952318 DOI: 10.3390/jpm12030420] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/15/2022] [Accepted: 03/04/2022] [Indexed: 12/22/2022] Open
Abstract
At present, artificial intelligence (AI) has already been applied in cardiovascular imaging (e.g., image segmentation, automated measurements, and eventually, automated diagnosis) and it has been propelled to the forefront of cardiovascular medical imaging research. In this review, we presented the current status of artificial intelligence applied to image analysis of coronary atherosclerotic plaques, covering multiple areas from plaque component analysis (e.g., identification of plaque properties, identification of vulnerable plaque, detection of myocardial function, and risk prediction) to risk prediction. Additionally, we discuss the current evidence, strengths, limitations, and future directions for AI in cardiac imaging of atherosclerotic plaques, as well as lessons that can be learned from other areas. The continuous development of computer science and technology may further promote the development of this field.
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Affiliation(s)
- Jia Zhang
- Hohhot Health Committee, Hohhot 010000, China;
| | - Ruijuan Han
- The People’s Hospital of Longgang District, Shenzhen 518172, China;
| | - Guo Shao
- The Third People’s Hospital of Longgang District, Shenzhen 518100, China;
| | - Bin Lv
- Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing 100037, China;
| | - Kai Sun
- The Third People’s Hospital of Longgang District, Shenzhen 518100, China;
- Correspondence:
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Gerbaud E, Weisz G, Tanaka A, Luu R, Osman HASH, Baldwin G, Coste P, Cognet L, Waxman S, Zheng H, Moses JW, Mintz GS, Akasaka T, Maehara A, Tearney GJ. Plaque burden can be assessed using intravascular optical coherence tomography and a dedicated automated processing algorithm: a comparison study with intravascular ultrasound. Eur Heart J Cardiovasc Imaging 2021; 21:640-652. [PMID: 31326995 DOI: 10.1093/ehjci/jez185] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 05/22/2019] [Accepted: 07/10/2019] [Indexed: 11/13/2022] Open
Abstract
AIMS Plaque burden (PB) measurement using intravascular optical coherence tomography (IVOCT) is currently thought to be inferior to intravascular ultrasound (IVUS). We developed an automated IVOCT image processing algorithm to enhance the external elastic lamina (EEL) contour. Thus, we investigated the accuracies of standard IVOCT and an IVOCT enhancement algorithm for measuring PB using IVUS as the reference standard. METHODS AND RESULTS The EEL-enhancement algorithm combined adaptive attenuation compensation, exponentiation, angular registration, and image averaging using three sequential frames. In two different laboratories with intravascular imaging expertise, PB was quantified on 200 randomized, matched IVOCT and IVUS images by four independent observers. Fibroatheroma, fibrocalcific plaque, fibrous plaque, pathological intimal thickening (PIT), and mixed plaque were included in each set. Pearson's correlation coefficients between IVUS and standard IVOCT measurements of PB were 0.61, 0.67, 0.76, 0.78, and 0.87 for fibroatheromas, mixed plaques, fibrocalcific plaques, fibrous plaques, and PIT plaques, respectively. Pearson's correlation coefficients increased to 0.81, 0.83, 0.83, 0.84, and 0.90 when using the EEL-enhanced images (P = 0.003, P = 0.004, P = 0.08, P = 0.12, and P = 0.23, respectively). EEL-enhanced IVOCT analysis was associated with a lower EEL-area measurement absolute error for fibroatheromas, mixed plaques, and all pooled plaques (P = 0.006, P = 0.02, and P < 0.001, respectively). Compared with standard IVOCT, the EEL-enhanced IVOCT images had a higher sensitivity (79% vs. 28%, P < 0.001) and specificity (98% vs. 85%, P = 0.03) for plaques with an IVUS PB ≥70%. CONCLUSION EEL-enhanced IVOCT can be used to reliably measure PB in all types of coronary atherosclerotic lesions, including fibroatheromas and mixed plaques.
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Affiliation(s)
- Edouard Gerbaud
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, BHX-604A, Boston, MA 02114, USA.,Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, 5 Avenue Magellan, Pessac 33600, France.,Bordeaux Cardio-Thoracic Research Centre, Bordeaux University, U1045, Hôpital Xavier Arnozan, Avenue du Haut Lévêque, Pessac 33600, France
| | - Giora Weisz
- Columbia University Medical Center, New York, NY, USA.,Cardiovascular Research Foundation, 1700 Broadway, 9th Floor, New York, NY 10019, USA.,Montefiore-Einstein Center for Heart and Vascular, The University Hospital for the Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY 10467, USA
| | - Atsushi Tanaka
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, BHX-604A, Boston, MA 02114, USA.,Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama Prefecture 641-8509, Japan
| | - Romain Luu
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, BHX-604A, Boston, MA 02114, USA.,Institut d'Optique Graduate School, CNRS-UMR 5298, Bordeaux University, Rue François Miterrand, Talence 33400, France
| | - Hany Ahmed Salaheldin Hussein Osman
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, BHX-604A, Boston, MA 02114, USA
| | - Grace Baldwin
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, BHX-604A, Boston, MA 02114, USA
| | - Pierre Coste
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, 5 Avenue Magellan, Pessac 33600, France.,Bordeaux Cardio-Thoracic Research Centre, Bordeaux University, U1045, Hôpital Xavier Arnozan, Avenue du Haut Lévêque, Pessac 33600, France
| | - Laurent Cognet
- Institut d'Optique Graduate School, CNRS-UMR 5298, Bordeaux University, Rue François Miterrand, Talence 33400, France
| | - Sergio Waxman
- Department of Cardiology, Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805, USA
| | - Hui Zheng
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jeffrey W Moses
- Columbia University Medical Center, New York, NY, USA.,Cardiovascular Research Foundation, 1700 Broadway, 9th Floor, New York, NY 10019, USA
| | - Gary S Mintz
- Columbia University Medical Center, New York, NY, USA.,Cardiovascular Research Foundation, 1700 Broadway, 9th Floor, New York, NY 10019, USA
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama Prefecture 641-8509, Japan
| | - Akiko Maehara
- Columbia University Medical Center, New York, NY, USA.,Cardiovascular Research Foundation, 1700 Broadway, 9th Floor, New York, NY 10019, USA
| | - Guillermo J Tearney
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street, BHX-604A, Boston, MA 02114, USA.,Department of Pathology, Massachusetts General Hospital and Harvard Medical School, 40 Blossom Street, Boston, MA 02114, USA.,Harvard-MIT Health Sciences and Technology, Boston, MA, USA
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Lee J, Prabhu D, Kolluru C, Gharaibeh Y, Zimin VN, Bezerra HG, Wilson DL. Automated plaque characterization using deep learning on coronary intravascular optical coherence tomographic images. BIOMEDICAL OPTICS EXPRESS 2019; 10:6497-6515. [PMID: 31853413 PMCID: PMC6913416 DOI: 10.1364/boe.10.006497] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/09/2019] [Accepted: 11/10/2019] [Indexed: 05/28/2023]
Abstract
Accurate identification of coronary plaque is very important for cardiologists when treating patients with advanced atherosclerosis. We developed fully-automated semantic segmentation of plaque in intravascular OCT images. We trained/tested a deep learning model on a folded, large, manually annotated clinical dataset. The sensitivities/specificities were 87.4%/89.5% and 85.1%/94.2% for pixel-wise classification of lipidous and calcified plaque, respectively. Automated clinical lesion metrics, potentially useful for treatment planning and research, compared favorably (<4%) with those derived from ground-truth labels. When we converted the results to A-line classification, they were significantly better (p < 0.05) than those obtained previously by using deep learning classifications of A-lines.
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Affiliation(s)
- Juhwan Lee
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - David Prabhu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Chaitanya Kolluru
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Yazan Gharaibeh
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Vladislav N. Zimin
- Cardiovascular Imaging Core Laboratory, Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
| | - Hiram G. Bezerra
- Cardiovascular Imaging Core Laboratory, Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
| | - David L. Wilson
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
- Department of Radiology, Case Western Reserve University, Cleveland, OH 44106, USA
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