Chen Zhao1, Aviral Vij2, Saurabh Malhotra2, Jinshan Tang3, Haipeng Tang4, Drew Pienta5, Zhihui Xu6, Weihua Zhou7. 1. Department of Applied Computing, Michigan Technological University, Houghton, MI, 49931, USA. 2. Division of Cardiology, Cook County Health and Hospitals System, Chicago, IL, 60612, USA; Division of Cardiology, Rush Medical College, Chicago, IL, 60612, USA. 3. Department of Applied Computing, Michigan Technological University, Houghton, MI, 49931, USA; Center of Biocomputing and Digital Health, Michigan Technological University, Houghton, MI, 49931, USA. 4. School of Computing Sciences and Computer Engineering, University of Southern Mississippi, Hattiesburg, MS, 39406, USA. 5. Department of Mechanical Engineering-Engineering Mechanics, Michigan Technological University, Houghton, MI, 49931, USA. 6. Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210000, China. Electronic address: wx_xzh@njmu.edu.cn. 7. Department of Applied Computing, Michigan Technological University, Houghton, MI, 49931, USA; Center of Biocomputing and Digital Health, Michigan Technological University, Houghton, MI, 49931, USA. Electronic address: whzhou@mtu.edu.
Abstract
BACKGROUND: Coronary artery disease (CAD) is the leading cause of death in the United States (US) and a major contributor to healthcare cost. Accurate segmentation of coronary arteries and detection of stenosis from invasive coronary angiography (ICA) are crucial in clinical decision making. PURPOSE: We aim to develop an automatic method to extract coronary arteries by deep learning and detect arterial stenosis from ICAs. METHODS: In this study, a deep learning model which integrates a feature pyramid with a U-Net++ model was developed to automatically segment coronary arteries in ICAs. A compound loss function which contains Dice loss, dilated Dice loss, and L2 regularization was utilized to train the proposed segmentation model. Following the segmentation, an algorithm which extracts vascular centerlines, calculates the diameters, and measures the stenotic levels, was developed to detect arterial stenosis. RESULTS AND CONCLUSIONS: In the dataset consisting of 314 ICAs obtained from 99 patients, the segmentation model achieved an average Dice score of 0.8899, a sensitivity of 0.8595, and a specificity of 0.9960. In addition, the stenosis detection algorithm achieved a true positive rate of 0.6840 and a positive predictive value of 0.6998 on all types of stenosis, which has great promise to advance to clinical uses and could provide auxiliary suggestions for CAD diagnosis and treatment.
BACKGROUND:Coronary artery disease (CAD) is the leading cause of death in the United States (US) and a major contributor to healthcare cost. Accurate segmentation of coronary arteries and detection of stenosis from invasive coronary angiography (ICA) are crucial in clinical decision making. PURPOSE: We aim to develop an automatic method to extract coronary arteries by deep learning and detect arterial stenosis from ICAs. METHODS: In this study, a deep learning model which integrates a feature pyramid with a U-Net++ model was developed to automatically segment coronary arteries in ICAs. A compound loss function which contains Dice loss, dilated Dice loss, and L2 regularization was utilized to train the proposed segmentation model. Following the segmentation, an algorithm which extracts vascular centerlines, calculates the diameters, and measures the stenotic levels, was developed to detect arterial stenosis. RESULTS AND CONCLUSIONS: In the dataset consisting of 314 ICAs obtained from 99 patients, the segmentation model achieved an average Dice score of 0.8899, a sensitivity of 0.8595, and a specificity of 0.9960. In addition, the stenosis detection algorithm achieved a true positive rate of 0.6840 and a positive predictive value of 0.6998 on all types of stenosis, which has great promise to advance to clinical uses and could provide auxiliary suggestions for CAD diagnosis and treatment.