Multimodality Image Fusion for Coronary Artery Disease Detection: Concepts and Latest Developments

A review on multimodal medical image fusion: Compendious analysis of medical modalities, multimodal databases, fusion techniques and quality metrics

BACKGROUND AND OBJECTIVES

Over the past two decades, medical imaging has been extensively apply to diagnose diseases. Medical experts continue to have difficulties for diagnosing diseases with a single modality owing to a lack of information in this domain. Image fusion may be use to merge images of specific organs with diseases from a variety of medical imaging systems. Anatomical and physiological data may be included in multi-modality image fusion, making diagnosis simpler. It is a difficult challenge to find the best multimodal medical database with fusion quality evaluation for assessing recommended image fusion methods. As a result, this article provides a complete overview of multimodal medical image fusion methodologies, databases, and quality measurements.

METHODS

In this article, a compendious review of different medical imaging modalities and evaluation of related multimodal databases along with the statistical results is provided. The medical imaging modalities are organized based on radiation, visible-light imaging, microscopy, and multimodal imaging.

RESULTS

The medical imaging acquisition is categorized into invasive or non-invasive techniques. The fusion techniques are classified into six main categories: frequency fusion, spatial fusion, decision-level fusion, deep learning, hybrid fusion, and sparse representation fusion. In addition, the associated diseases for each modality and fusion approach presented. The quality assessments fusion metrics are also encapsulated in this article.

CONCLUSIONS

This survey provides a baseline guideline to medical experts in this technical domain that may combine preoperative, intraoperative, and postoperative imaging, Multi-sensor fusion for disease detection, etc. The advantages and drawbacks of the current literature are discussed, and future insights are provided accordingly.

Ability of artificial intelligence to diagnose coronary artery stenosis using hybrid images of coronary computed tomography angiography and myocardial perfusion SPECT

BACKGROUND

Detecting culprit coronary arteries in patients with ischemia using only myocardial perfusion single-photon emission computed tomography (SPECT) can be challenging. This study aimed to improve the detection of culprit regions using an artificial neural network (ANN) to analyze hybrid images of coronary computed tomography angiography (CCTA) and myocardial perfusion SPECT.

METHODS

This study enrolled 59 patients with stable coronary artery disease (CAD) who had been assessed by coronary angiography within 60 days of myocardial perfusion SPECT. Two nuclear medicine physicians interpreted the myocardial perfusion SPECT and hybrid images with four grades of confidence, then drew regions on polar maps to identify culprit coronary arteries. The gold standard was determined by the consensus of two other nuclear cardiology specialist based on coronary angiography findings and clinical information. The ability to detect culprit coronary arteries was compared among experienced nuclear cardiologists and the ANN. Receiver operating characteristics (ROC) curves were analyzed and areas under the ROC curves (AUC) were determined.

RESULTS

Using hybrid images, observer A detected CAD in the right (RCA), left anterior descending (LAD), and left circumflex (LCX) coronary arteries with 83.6%, 89.3%, and 94.4% accuracy, respectively and observer B did so with 72.9%, 84.2%, and 89.3%, respectively. The ANN was 79.1%, 89.8%, and 89.3% accurate for each coronary artery. Diagnostic accuracy was comparable between the ANN and experienced nuclear medicine physicians. The AUC was significantly improved using hybrid images in the RCA region (observer A: from 0.715 to 0.835, p = 0.0031; observer B: from 0.771 to 0.843, p = 0.042). To detect culprit coronary arteries in perfusion defects of the inferior wall without using hybrid images was problematic because the perfused areas of the LCX and RCA varied among individuals.

CONCLUSIONS

Hybrid images of CCTA and myocardial perfusion SPECT are useful for detecting culprit coronary arteries. Diagnoses using artificial intelligence are comparable to that by nuclear medicine physicians.