Automatic coronary artery calcium scoring from unenhanced-ECG-gated CT using deep learning

• DOI: 10.1016/j.diii.2021.05.004
• Publication Date: 2021-06-05T07:19:56Z
• Authors: Nicolas Gogin; Mario Viti; Luc Nicodème; Mickaël Ohana; Hugues Talbot; Umit Gencer; Magloire Mekukoso...; Thomas Caramella; Yann Diascorn; Jean-Yves Airaud; Marc-Samir Guillot; Zoubir Bensalah; Caroline Dam Hieu; Bassam Abdallah; Imad Bousaid; Nathalie Lassau; Elie Mousseaux
• Keywords: X-ray computed; Deep learning; Coronary Artery Disease; [INFO] Computer Science [cs]; Coronary Vessels; Multidetector computed tomography; Electrocardiography; 03 medical and health sciences; Deep Learning; 0302 clinical medicine; Artificial Intelligence; Humans; [INFO]Computer Science [cs]; Calcium; Convolutional neural networks (CNN); Tomography, X-Ray Computed; Tomography

The purpose of this study was to develop and evaluate an algorithm that can automatically estimate the amount of coronary artery calcium (CAC) from unenhanced electrocardiography (ECG)-gated computed tomography (CT) cardiac volume acquisitions by using convolutional neural networks (CNN).The method used a set of five CNN with three-dimensional (3D) U-Net architecture trained on a database of 783 CT examinations to detect and segment coronary artery calcifications in a 3D volume. The Agatston score, the conventional CAC scoring, was then computed slice by slice from the resulting segmentation mask and compared to the ground truth manually estimated by radiologists. The quality of the estimation was assessed with the concordance index (C-index) on CAC risk category on a separate testing set of 98 independent CT examinations.The final model yielded a C-index of 0.951 on the testing set. The remaining errors of the method were mainly observed on small-size and/or low-density calcifications, or calcifications located near the mitral valve or ring.The deep learning-based method proposed here to compute automatically the CAC score from unenhanced-ECG-gated cardiac CT is fast, robust and yields accuracy similar to those of other artificial intelligence methods, which could improve workflow efficiency, eliminating the time spent on manually selecting coronary calcifications to compute the Agatston score.