Automatic identification of patients with functionally significant obstructive coronary artery disease using non-invasive cardiac CT

Coronary artery disease (CAD) remains the first cause of morbidity and mortality in the Western world and it is expected that this trend will continue in the coming years. In clinical routine, patients with CAD are increasingly identified using non-invasive coronary CT angiography (CCTA), a non-invasive imaging tool for detection and exclusion of the obstructive coronary artery stenosis. Despite its high sensitivity, CCTA is currently not capable of determining the functional significance of the detected stenosis. Therefore, after undergoing CCTA, many patients undergo invasive coronary angiography (ICA).

In this project, we design a quantitative method to determine which coronary artery stenoses as seen on CCTA images are functionally significant, and thereby to identify patients who need to undergo invasive coronary catheterization and spare those who do not.

The video below describes our method for coronary calcium scoring in contrast-enhanced cardiac CT, which was presented at MICCAI 2015.

 



A slice from contrast enhanced cardiac CT scan (left) and corresponding slice from cardiac CT scan without contrast enhancement. Areas indicated in blue show calcified plaque in the left coronary artery.


Researchers


Papers in international journals

1.J.M. Wolterink, R.W. van Hamersvelt, M.A. Viergever, T. Leiner, I. Isgum. Coronary artery centerline extraction in cardiac CT angiography using a CNN-based orientation classifier. Medical Image Analysis, 2019, vol. 51, pp. 46-60 Abstract | pdf )
2.M. Zreik, R.W. van Hamersvelt, J.M. Wolterink, T. Leiner, M.A. Viergever, I. Isgum. A recurrent CNN for automatic detection and classification of coronary artery plaque and stenosis in coronary CT angiography. IEEE Transactions on Medical Imaging, in press, 2019 Abstract | pdf )
3.R. W. van Hamersvelt*, M. Zreik*, M. Voskuil, M. A. Viergever, I. Išgum, T. Leiner. Deep learning analysis of left ventricular myocardium in CT angiographic intermediate degree coronary stenosis improves the diagnostic accuracy for identification of functionally significant stenosis . European Radiology, in press, 2018, (*equal contribution) ( pdf )
4.M. Zreik, N. Lessmann, R. van Hamersvelt, J.M. Wolterink, M. Voskuil, M.A. Viergever, T. Leiner, I. Išgum. Deep learning analysis of the myocardium in coronary CT angiography for identification of patients with functionally significant coronary artery stenosis. Medical Image Analysis, 2018, vol. 44, pp. 72-85 Abstract | pdf )
5.J.M. Wolterink, T. Leiner, M.A. Viergever, I. Isgum. Generative adversarial networks for noise reduction in low-dose CT. IEEE Transactions on Medical Imaging, 2017, vol. 36, nr. 12, pp. 2536 - 2545 Abstract | pdf )
6.J.M. Wolterink, T. Leiner, B.D. de Vos, R.W. van Hamersvelt, M.A. Viergever, I. Isgum. Automatic coronary artery calcium scoring in cardiac CT angiography using paired convolutional neural networks. Medical Image Analysis, 2016, vol. 34, pp. 123-136 Abstract )

Papers in conference proceedings

1.M. Zreik, R. W. van Hamersvelt, J. M. Wolterink, T. Leiner, M. A. Viergever, I. Išgum. Automatic Detection and Characterization of Coronary Artery Plaque and Stenosis using a Recurrent Convolutional Neural Network in Coronary CT Angiography. In: Medical Imaging with Deep Learning (MIDL 2018), 2018 Abstract | pdf )
2.J.M. Wolterink, T. Leiner, M.A. Viergever, I. Isgum. Automatic segmentation and disease classification using cardiac cine MR images. In: Statistical Atlases and Computational Models of the Heart. ACDC and MMWHS Challenges. STACOM 2017, 2018, vol. 10663, pp. 101-110 Abstract | pdf )
3.J.M. Wolterink, T. Leiner, M.A. Viergever, I. Isgum. Dilated convolutional neural networks for cardiovascular MR segmentation in congenital heart disease. In: HVSMR 2016: MICCAI Workshop on Whole-Heart and Great Vessel Segmentation from 3D Cardiovascular MRI in Congenital Heart Disease, 2017, vol. 10129, pp. 95-102 Abstract )
4.P. Moeskops, J.M. Wolterink, B.H.M. van der Velden, K.G.A. Gilhuijs, T. Leiner, M.A. Viergever, I. Isgum. Deep learning for multi-task medical image segmentation in multiple modalities. In: Medical Image Computing and Computer-Assisted Intervention, 2016, vol. 9901, pp. 478-486 Abstract )
5.M. Zreik, T. Leiner, B.D. de Vos, R.W. van Hamersvelt, M.A. Viergever, I. Isgum. Automatic segmentation of the left ventricle in cardiac CT angiography using convolutional neural networks. In: IEEE International Symposium on Biomedical Imaging, 2016, pp. pp. 40-43
6.J.M. Wolterink, T. Leiner, M.A. Viergever, I. Isgum. Automatic coronary calcium scoring in cardiac CT angiography using convolutional neural networks. In: Medical Image Computing and Computer-Assisted Intervention, 2015, vol. 9349, pp. 589-596 Abstract )

Abstracts

1.R. W. van Hamersvelt, M. Zreik, M. Voskuil, I. Isgum, T. Leiner. Deep learning-based analysis of the left ventricular myocardium in coronary CTA images improves specificity for detection of functionally significant coronary artery stenosis. European Congress of Radiology (ECR), 2018 Abstract )
2.R. van Hamersvelt, M. Zreik, N. Lessmann, J. Wolterink, M. Voskuil, M.A Viergever, T. Leiner, I. Isgum. Improving Specificity of Coronary CT Angiography for the Detection of Functionally Significant Coronary Artery Disease: A Deep Learning Approach. Radiological Society of North America, 103rd Annual Meeting, 2017 Abstract )
3.M. Zreik, N. Lessmann, R. van Hamersvelt, J. Wolterink, M. Voskuil, M.A Viergever, T. Leiner, I. Isgum. Deep learning analysis of the left ventricular myocardium in cardiac CT images enables detection of functionally significant coronary artery stenosis regardless of coronary anatomy. Radiological Society of North America, 103rd Annual Meeting, 2017 Abstract )
4.J.M. Wolterink, T. Leiner, M.A. Viergever, I. Isgum. An adversarial deep learning approach to coronary CT radiation reduction. Society of Cardiovascular Computed Tomography, 12th Annual Scientific Meeting, 2017 Abstract )