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Automatic coronary calcium scoring in chest CT using a deep neural network in direct comparison with non-contrast cardiac CT: A validation study.

Abstract：

PURPOSE:To evaluate deep-learning based calcium quantification on Chest CT scans compared with manual evaluation, and to enable interpretation in terms of the traditional Agatston score on dedicated Cardiac CT. METHODS:Automated calcium quantification was performed using a combination of deep-learning convolution neural networks with a ResNet-architecture for image features and a fully connected neural network for spatial coordinate features. Calcifications were identified automatically, after which the algorithm automatically excluded all non-coronary calcifications using coronary probability maps and aortic segmentation. The algorithm was first trained on cardiac-CTs and refined on non-triggered chest-CTs. This study used on 95 patients (cohort 1), who underwent both dedicated calcium scoring and chest-CT acquisitions using the Agatston score as reference standard and 168 patients (cohort 2) who underwent chest-CT only using qualitative expert assessment for external validation. Results from the deep-learning model were compared to Agatston-scores(cardiac-CTs) and manually determined calcium volumes(chest-CTs) and risk classifications. RESULTS:In cohort 1, the Agatston score and AI determined calcium volume shows high correlation with a correlation coefficient of 0.921(p < 0.001) and R2 of 0.91. According to the Agatston categories, a total of 67(70 %) were correctly classified with a sensitivity of 91 % and specificity of 92 % in detecting presence of coronary calcifications. Manual determined calcium volume on chest-CT showed excellent correlation with the AI volumes with a correlation coefficient of 0.923(p < 0.001) and R2 of 0.96, no significant difference was found (p = 0.247). According to qualitative risk classifications in cohort 2, 138(82 %) cases were correctly classified with a k-coefficient of 0.74, representing good agreement. All wrongly classified scans (30(18 %)) were attributed to an adjacent category. CONCLUSION:Artificial intelligence based calcium quantification on chest-CTs shows good correlation compared to reference standards. Fully automating this process may reduce evaluation time and potentially optimize clinical calcium scoring without additional acquisitions.

journal_name

Eur J Radiol

journal_title

European journal of radiology

authors

van Assen M,Martin SS,Varga-Szemes A,Rapaka S,Cimen S,Sharma P,Sahbaee P,De Cecco CN,Vliegenthart R,Leonard TJ,Burt JR,Schoepf UJ

doi

10.1016/j.ejrad.2020.109428

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

109428

eissn

0720-048X

issn

1872-7727

pii

S0720-048X(20)30618-5

journal_volume

134

pub_type

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Automatic coronary calcium scoring in chest CT using a deep neural network in direct comparison with non-contrast cardiac CT: A validation study.