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Sehly A, He A, Jaltotage B, Lan NSR, Joyner J, Flack J, Sokolov J, Chronos N, Ko B, Chow B, Dwivedi G, Ihdayhid AR. Coronary artery stenosis and vulnerable plaque quantification on CCTA by deep learning methods. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Coronary computed tomography angiography (CCTA) has emerged as a reliable non-invasive modality to assess coronary artery stenosis (CAS) severity and vulnerable plaque (VP). However, comprehensive CCTA assessment, especially VP, is time-consuming and dependent on reader expertise, limiting CCTA's true potential.
Purpose
In this study, we aim to develop and validate a deep learning (DL) based system capable of evaluating CAS severity and characterising VP on CCTA.
Methods
A DL system was trained to assess CAS severity on 3909 expert annotated vessels. A subset of 824 vessels was used to train the model to assess for the presence of VP. The model was based on a 2D U-Net and 3D convolutional neural network architecture. The system automatically performed vessel tracking and segmentation to quantify stenosis severity and characterise the presence of VP. CAS severity was categorised as 0%, 1–49% and ≥50%. VP was defined as: low attenuation plaque (LAP; ≤30 Hounsfield units), positive remodelling (PR; ≥10% diameter) and spotty calcification (SC; <3mm). The model was then tested on 1435 vessels for CAS (mean calcium score 197±502) and a subset of 365 vessels for VP (mean calcium score 419±551), and its diagnostic performance compared with expert readers.
Results
The CAS testing data had a prevalence of 75% (1080/1435), 18% (257/1435) and 6.8% (98/1435) for 0%, 1–49% and ≥50% stenosis, respectively. VP was present in 20% (72/365) in the respective dataset with 44% (32/72) LAP, 19% (14/72) PR and 36% (26/72) SC. Average analysis time for CAS severity and VP was 3.7±2.0s and 3.5±1.8s, respectively. Diagnostic performance of our system is summarised in Tables 1 (CAS severity) and 2 (VP characteristics).
Conclusions
We developed an DL based system capable of rapidly evaluating CAS severity and characterising VP on CCTA. Our system demonstrated high specificity and accuracy for both CAS severity and VP quantification when compared with expert readers.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Sehly
- Fiona Stanley Hospital , Perth , Australia
| | - A He
- Fiona Stanley Hospital , Perth , Australia
| | | | - N S R Lan
- Fiona Stanley Hospital , Perth , Australia
| | | | | | - J Sokolov
- University of Southern California, School of Medicine , Los Angeles , United States of America
| | - N Chronos
- School of Medicine , Stanford , United States of America
| | - B Ko
- Monash Heart , Melbourne , Australia
| | - B Chow
- Ottawa Heart Institute , Ottawa , Canada
| | - G Dwivedi
- Harry Perkins Institute of Medical Research , Perth , Australia
| | - A R Ihdayhid
- Harry Perkins Institute of Medical Research , Perth , Australia
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He A, Sehly A, Jaltotage B, Lan N, Joyner J, Flack J, Sokolov J, Chronos N, Ko B, Chow B, Dwivedi G, Ihdayhid A. 448 Comprehensive Assessment Of Coronary Artery Disease On CCTA Using Deep Learning Methods. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sehly A, He A, Lan N, Jaltotage B, Joyner J, Flack J, Kwok S, Chow B, Ko B, Ridner M, Ihdayhid A, Dwivedi G. 402 Artificial Intelligence Based CT Quantification Of Left Ventricular Mass. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Huangfu G, Jaltotage B, Pang J, Lan N, Abraham A, Otto J, Ihdayhid A, Rankin J, Watts G, Ayonrinde O, Dwivedi G. CT Evaluation of Hepatic Fat: A Novel Marker for High-Risk Coronary Atherosclerosis in Familial Hypercholesterolaemia. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sehly A, He A, Lan N, Jaltotage B, Kwok S, Flack J, Joyner J, Sokolov J, Chow B, Ko B, Figtree G, Ihdayhid A, Dwivedi G. Fully Automated Characterisation of Vulnerable Plaque Features on Cardiac CT Using Deep Learning Techniques. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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He A, Sehly A, Lan N, Jaltotage B, Kwok S, Flack J, Joyner J, Chronos N, Chow B, Ko B, Figtree G, Dwivedi G, Ihdayhid A. Automated Assessment of CT Coronary Artery Stenosis Using a Deep Learning Approach. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Jaltotage B, Pang J, Abraham A, Krishnan A, Chow B, Ihdayhid A, Mohd S, Watts G, Dwivedi G. Value Of Atherosclerotic Plaque Characteristics And Pericoronary Adipose Tissue In Predicting Outcomes In Familial Hypercholesterolemia: Should CCTA Be Carried Out In All Adult Patients With FH? J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jaltotage B, Abraham A, Pang J, Krishnan A, Chow B, Ihdayhid A, Lu J, Watts G, Dwivedi G. Can We Predict High-risk Plaques In Familial Hypercholesterolemia Using Clinical Variables And Coronary Artery Calcium. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jaltotage B, Pang J, Abraham A, Krishnan A, Chow B, Ihdayhid A, Mohd S, Watts G, Dwivedi G. Value of Atherosclerotic Plaque Characteristics and Pericoronary Adipose Tissue in Predicting Outcomes in Familial Hypercholesterolaemia: Should CCTA be Carried out in all Adult Patients With FH? Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jaltotage B, Abraham A, Pang J, Krishnan A, Chow B, Ihdayhid A, Lu J, Watts G, Dwivedi G. Can we Predict High-Risk Plaques in Familial Hypercholesterolaemia Using Clinical Variables and Coronary Artery Calcium? Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jaltotage B, Ali U, Dorai-Raj A, Sanfilippo F, Rankin J, Dwivedi G. Q Fever Endocarditis: A Review of 135 Reported Cases. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jaltotage B, Gupta A, Ali U, Parsons R, Rankin J, Dwivedi G. Coronary CT Angiography for Allocation of Lipid Lowering Therapy: A Tertiary Centre Experience. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dorai-Raj A, Dwivedi G, Rankin J, Jaltotage B, Stamp N. The Effect of Embolic Phenomenon on Surgery in Native versus Prosthetic Valve Endocarditis. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Maggiore P, Bellinge J, Chieng D, White D, Lan N, Jaltotage B, Ali U, Gordon M, Chung K, Stobie P, Ng J, Hankey G, McQuillan B. Ischaemic Stroke and the Echo ‘Bubble Study’: Are we Screening the Right Patients? A Multicentre Experience from Western Australia. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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