OP1 A novel coronary computed tomography angiography deep-learning methodology for coronary atheroma assessment trained using near-infrared spectroscopy-intravascular ultrasound

Abstract

Objective We developed and validated a novel deep-learning (DL)-methodology for coronary CT angiography (CCTA) plaque quantification and characterisation trained using near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS). Methods Seventy patients with stable angina were prospectively recruited, and underwent 3rd generation, dual-source CCTA and 3-vessel NIRS-IVUS imaging (NCT03556644). The lumen and vessel wall contours on CCTA and NIRS-IVUS were manually drawn and matched using in-house developed software. A novel DL convolutional neural network was trained using the NIRS-IVUS annotations as the ground truth in 138 vessels and applied to automatically segment a test set of 48 vessels and its estimations were compared with the estimations of NIRS-IVUS and the experts. Results The DL-methodology was superior to experts for estimating lumen volume (ICC 0.980 vs 0.938), vessel volume (ICC 0.991 vs 0.829), total atheroma volume (ICC 0.969 vs 0.520), percentage atheroma volume (ICC 0.786 vs 0.463) and lipid core burden index (LCBI; ICC 0.794 vs 0.492, all p<0.001). The DL-methodology estimations of calcific burden index (CaBI) were also superior compared to experts without statistical significance (ICC 0.931 vs 0.745, p=0.140). In addition, the DL-methodology was superior for morphological assessment of lumen area (dice similarity coefficient (DSC) 0.86±0.04 vs 0.82±0.03, hausdorff distance (HD) 0.41±0.10 vs 0.45±0.11 and mean distance 0.20±0.06 vs 0.24±0.07, all p<0.001) and vessel area (DSC 0.86±0.04 vs 0.73±0.06, HD 0.47±0.10 vs 0.80±0.17 and mean distance 0.23±0.05 vs 0.48±0.12, all p<0.001). Conclusion Our novel CCTA DL-methodology trained on NIRS-IVUS enables accurate and rapid coronary plaque quantification and characterisation.

Authors 18

1. Anantharaman Ramasamy

   Queen Mary University of London · Barts Health NHS Trust · William Harvey Research Institute

   Affiliation as printed

   Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK

   Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK

2. Hessam Sokooti Aachen Division of Image Processing Department of Radiology, Leiden University Medical Center

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

3. Xiaotong Zhang Aachen Division of Image Processing Department of Radiology, Leiden University Medical Center

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

4. Evangelia Tzorovili

   Queen Mary University of London

   Affiliation as printed

   Pragmatic Clinical Trials Unit, Centre for Evaluation and Methods, Wolfson Institute of Population Health, Queen Mary University of London, London, UK

5. Retesh Bajaj

   Queen Mary University of London · Barts Health NHS Trust · William Harvey Research Institute

   Affiliation as printed

   Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK

   Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK

6. Pieter H. Kitslaar Aachen Division of Image Processing Department of Radiology, Leiden University Medical Center

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

   Medis Medical Imaging, Leiden, The Netherlands

7. Alexander Broersen Aachen Division of Image Processing Department of Radiology, Leiden University Medical Center

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

8. Rajiv A. Amersey

   Barts Health NHS Trust

   Affiliation as printed

   Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK

9. Mick Ozkor

   Barts Health NHS Trust

   Affiliation as printed

   Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK

10. Johan H. C. Reiber Aachen Division of Image Processing Department of Radiology, Leiden University Medical Center

    Leiden University · Leiden University Medical Center

    Affiliation as printed

    Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

    Medis Medical Imaging, Leiden, The Netherlands

11. Jouke Dijkstra Aachen Division of Image Processing Department of Radiology, Leiden University Medical Center

    Leiden University · Leiden University Medical Center

    Affiliation as printed

    Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

12. Patrick W.J.C. Serruys

    Ollscoil na Gaillimhe – University of Galway · Imperial College London

    Affiliation as printed

    Department of Cardiology, National University of Ireland, Galway, Ireland

    Faculty of Medicine, National Heart and Lung Institute, Imperial College London, UK

13. Ryo Torii

    University College London

    Affiliation as printed

    Department of Mechanical Engineering, University College London, London, UK

14. James Moon

    Barts Health NHS Trust · University College London

    Affiliation as printed

    Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK

    Institute of Cardiovascular Sciences, University College London, London, UK

15. Anthony Mathur

    Queen Mary University of London · Barts Health NHS Trust · William Harvey Research Institute

    Affiliation as printed

    Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK

    Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK

16. Andreas Baumbach

    Queen Mary University of London · Barts Health NHS Trust · William Harvey Research Institute

    Affiliation as printed

    Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK

    Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK

17. Francesca Pugliese

    Queen Mary University of London · Barts Health NHS Trust · William Harvey Research Institute

    Affiliation as printed

    Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK

    Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK

18. Christos V. Bourantas

    Queen Mary University of London · Barts Health NHS Trust · William Harvey Research Institute · University College London

    Affiliation as printed

    Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK

    Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK

    Institute of Cardiovascular Sciences, University College London, London, UK