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Araki T, Ikeda N, Dey N, Acharjee S, Molinari F, Saba L, Godia EC, Nicolaides A, Suri JS. Shape-based approach for coronary calcium lesion volume measurement on intravascular ultrasound imaging and its association with carotid intima-media thickness. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2015; 34:469-482. [PMID: 25715368 DOI: 10.7863/ultra.34.3.469] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Coronary calcification plays an important role in diagnostic classification of lesion subsets. According to histopathologic studies, vulnerable atherosclerotic plaque contains calcified deposits, and there can be considerable variation in the extent and degree of calcification. Intravascular ultrasound (IVUS) has demonstrated its role in imaging coronary arteries, thereby displaying calcium lesions. The aim of this work was to develop a fully automated system for detection, area and volume measurement, and characterization of the largest calcium deposits in coronary arteries. Furthermore, we demonstrate the correlation between the coronary calcium IVUS volume and the neurologic risk biomarker B-mode carotid intima-media thickness (IMT). METHODS Our system automatically detects the frames with calcium, identifies the largest calcium region, and performs shape-based volume measurements. The carotid IMT is measured by using AtheroEdge software (AtheroPoint, LLC) on B-mode ultrasound imaging. RESULTS Our database consists of low-contrast IVUS videos and corresponding B-mode images from 100 patients. Our experiments showed that the correlation between calcium volumes and carotid IMT was higher for the left carotid artery compared to the right carotid artery (r = 0.066 for the left carotid artery and 0.121 for the right carotid artery). We obtained 97% accuracy for automated calcium detection compared against the scoring given by our expert radiologists. Furthermore, we benchmarked shape-based volume measurement against the conventional method, which used integration of regions and showed a correlation of 84%. CONCLUSIONS Since carotid IMT is an independent prognostic factor for myocardial infarction, and calcium lesions are correlated with stroke risk, we believe that this automated system for calcium volume measurement could be useful for assessing patients' cardiovascular risk.
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Affiliation(s)
- Tadashi Araki
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan (T.A.); Division of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan (N.I.); Point of Care Devices, Global Biomedical Technologies, Inc, Roseville, California USA (N.D., S.A., J.S.S.); Biolab, Department of Electronics, Politecnico di Torino, Torino, Italy (F.M.); Azienda Ospedaliero Universitaria di Cagliari-Polo di Monserrato, Università di Cagliari, Cagliari, Italy (L.S.); Institut Hospital del Mar d'Investigacions Mèdiques, Hospital del Mar, Barcelona, Spain (E.C.G.); Vascular Screening and Diagnostic Center, London, England (A.N.); Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus (A.N.); Diagnostic and Monitoring Division, AtheroPoint, LLC, Roseville, California USA (J.S.S.); and Department of Electrical Engineering (Affiliate), Idaho State University, Pocatello, Idaho USA (J.S.S.)
| | - Nobutaka Ikeda
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan (T.A.); Division of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan (N.I.); Point of Care Devices, Global Biomedical Technologies, Inc, Roseville, California USA (N.D., S.A., J.S.S.); Biolab, Department of Electronics, Politecnico di Torino, Torino, Italy (F.M.); Azienda Ospedaliero Universitaria di Cagliari-Polo di Monserrato, Università di Cagliari, Cagliari, Italy (L.S.); Institut Hospital del Mar d'Investigacions Mèdiques, Hospital del Mar, Barcelona, Spain (E.C.G.); Vascular Screening and Diagnostic Center, London, England (A.N.); Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus (A.N.); Diagnostic and Monitoring Division, AtheroPoint, LLC, Roseville, California USA (J.S.S.); and Department of Electrical Engineering (Affiliate), Idaho State University, Pocatello, Idaho USA (J.S.S.)
| | - Nilanjan Dey
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan (T.A.); Division of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan (N.I.); Point of Care Devices, Global Biomedical Technologies, Inc, Roseville, California USA (N.D., S.A., J.S.S.); Biolab, Department of Electronics, Politecnico di Torino, Torino, Italy (F.M.); Azienda Ospedaliero Universitaria di Cagliari-Polo di Monserrato, Università di Cagliari, Cagliari, Italy (L.S.); Institut Hospital del Mar d'Investigacions Mèdiques, Hospital del Mar, Barcelona, Spain (E.C.G.); Vascular Screening and Diagnostic Center, London, England (A.N.); Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus (A.N.); Diagnostic and Monitoring Division, AtheroPoint, LLC, Roseville, California USA (J.S.S.); and Department of Electrical Engineering (Affiliate), Idaho State University, Pocatello, Idaho USA (J.S.S.)
| | - Suvojit Acharjee
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan (T.A.); Division of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan (N.I.); Point of Care Devices, Global Biomedical Technologies, Inc, Roseville, California USA (N.D., S.A., J.S.S.); Biolab, Department of Electronics, Politecnico di Torino, Torino, Italy (F.M.); Azienda Ospedaliero Universitaria di Cagliari-Polo di Monserrato, Università di Cagliari, Cagliari, Italy (L.S.); Institut Hospital del Mar d'Investigacions Mèdiques, Hospital del Mar, Barcelona, Spain (E.C.G.); Vascular Screening and Diagnostic Center, London, England (A.N.); Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus (A.N.); Diagnostic and Monitoring Division, AtheroPoint, LLC, Roseville, California USA (J.S.S.); and Department of Electrical Engineering (Affiliate), Idaho State University, Pocatello, Idaho USA (J.S.S.)
| | - Filippo Molinari
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan (T.A.); Division of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan (N.I.); Point of Care Devices, Global Biomedical Technologies, Inc, Roseville, California USA (N.D., S.A., J.S.S.); Biolab, Department of Electronics, Politecnico di Torino, Torino, Italy (F.M.); Azienda Ospedaliero Universitaria di Cagliari-Polo di Monserrato, Università di Cagliari, Cagliari, Italy (L.S.); Institut Hospital del Mar d'Investigacions Mèdiques, Hospital del Mar, Barcelona, Spain (E.C.G.); Vascular Screening and Diagnostic Center, London, England (A.N.); Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus (A.N.); Diagnostic and Monitoring Division, AtheroPoint, LLC, Roseville, California USA (J.S.S.); and Department of Electrical Engineering (Affiliate), Idaho State University, Pocatello, Idaho USA (J.S.S.)
| | - Luca Saba
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan (T.A.); Division of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan (N.I.); Point of Care Devices, Global Biomedical Technologies, Inc, Roseville, California USA (N.D., S.A., J.S.S.); Biolab, Department of Electronics, Politecnico di Torino, Torino, Italy (F.M.); Azienda Ospedaliero Universitaria di Cagliari-Polo di Monserrato, Università di Cagliari, Cagliari, Italy (L.S.); Institut Hospital del Mar d'Investigacions Mèdiques, Hospital del Mar, Barcelona, Spain (E.C.G.); Vascular Screening and Diagnostic Center, London, England (A.N.); Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus (A.N.); Diagnostic and Monitoring Division, AtheroPoint, LLC, Roseville, California USA (J.S.S.); and Department of Electrical Engineering (Affiliate), Idaho State University, Pocatello, Idaho USA (J.S.S.)
| | - Elisa Cuadrado Godia
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan (T.A.); Division of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan (N.I.); Point of Care Devices, Global Biomedical Technologies, Inc, Roseville, California USA (N.D., S.A., J.S.S.); Biolab, Department of Electronics, Politecnico di Torino, Torino, Italy (F.M.); Azienda Ospedaliero Universitaria di Cagliari-Polo di Monserrato, Università di Cagliari, Cagliari, Italy (L.S.); Institut Hospital del Mar d'Investigacions Mèdiques, Hospital del Mar, Barcelona, Spain (E.C.G.); Vascular Screening and Diagnostic Center, London, England (A.N.); Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus (A.N.); Diagnostic and Monitoring Division, AtheroPoint, LLC, Roseville, California USA (J.S.S.); and Department of Electrical Engineering (Affiliate), Idaho State University, Pocatello, Idaho USA (J.S.S.)
| | - Andrew Nicolaides
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan (T.A.); Division of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan (N.I.); Point of Care Devices, Global Biomedical Technologies, Inc, Roseville, California USA (N.D., S.A., J.S.S.); Biolab, Department of Electronics, Politecnico di Torino, Torino, Italy (F.M.); Azienda Ospedaliero Universitaria di Cagliari-Polo di Monserrato, Università di Cagliari, Cagliari, Italy (L.S.); Institut Hospital del Mar d'Investigacions Mèdiques, Hospital del Mar, Barcelona, Spain (E.C.G.); Vascular Screening and Diagnostic Center, London, England (A.N.); Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus (A.N.); Diagnostic and Monitoring Division, AtheroPoint, LLC, Roseville, California USA (J.S.S.); and Department of Electrical Engineering (Affiliate), Idaho State University, Pocatello, Idaho USA (J.S.S.)
| | - Jasjit S Suri
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan (T.A.); Division of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan (N.I.); Point of Care Devices, Global Biomedical Technologies, Inc, Roseville, California USA (N.D., S.A., J.S.S.); Biolab, Department of Electronics, Politecnico di Torino, Torino, Italy (F.M.); Azienda Ospedaliero Universitaria di Cagliari-Polo di Monserrato, Università di Cagliari, Cagliari, Italy (L.S.); Institut Hospital del Mar d'Investigacions Mèdiques, Hospital del Mar, Barcelona, Spain (E.C.G.); Vascular Screening and Diagnostic Center, London, England (A.N.); Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus (A.N.); Diagnostic and Monitoring Division, AtheroPoint, LLC, Roseville, California USA (J.S.S.); and Department of Electrical Engineering (Affiliate), Idaho State University, Pocatello, Idaho USA (J.S.S.).
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van Velzen JE, de Graaf FR, de Graaf MA, Schuijf JD, Kroft LJ, de Roos A, Reiber JHC, Bax JJ, Jukema JW, Boersma E, Schalij MJ, van der Wall EE. Comprehensive assessment of spotty calcifications on computed tomography angiography: comparison to plaque characteristics on intravascular ultrasound with radiofrequency backscatter analysis. J Nucl Cardiol 2011; 18:893-903. [PMID: 21769702 PMCID: PMC3175045 DOI: 10.1007/s12350-011-9428-2] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Accepted: 06/28/2011] [Indexed: 10/25/2022]
Abstract
BACKGROUND The purpose of the study was to systematically compare calcification patterns in plaques on computed tomography angiography (CTA) with plaque characteristics on intravascular ultrasound with radiofrequency backscatter analysis (IVUS-VH). METHODS AND RESULTS In total, 108 patients underwent CTA and IVUS-VH. On CTA, calcification patterns in plaques were classified as non-calcified, spotty or dense calcifications. Plaques with spotty calcifications were differentiated into small spotty (<1 mm), intermediate spotty (1-3 mm) and large spotty calcifications (≥3 mm). Plaque characteristics deemed more high-risk on IVUS-VH were defined by % necrotic core (NC) and presence of thin cap fibroatheroma (TCFA). Overall, 300 plaques were identified both on CTA and IVUS-VH. % NC core was significantly higher in plaques with small spotty calcifications as compared to non-calcified plaques (20% vs 13%, P = .006). In addition, there was a trend for a higher % NC in plaques with small spotty calcifications than in plaques with intermediate spotty calcifications (20% vs 14%, P = .053). Plaques with small spotty calcifications had the highest % TCFA as compared to large spotty and dense calcifications (31% vs 9% and 31% vs 6%, P < .05). CONCLUSION Plaques with small spotty calcifications on CTA were related to plaque characteristics deemed more high-risk on IVUS-VH. Therefore, CTA may be valuable in the assessment of the vulnerable plaque.
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Affiliation(s)
- Joëlla E. van Velzen
- Department of Cardiology, Leiden University Medical Center, Postal Zone: C5-P, P.O. Box 9600, 2333 ZA Leiden, The Netherlands
- The Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - Fleur R. de Graaf
- Department of Cardiology, Leiden University Medical Center, Postal Zone: C5-P, P.O. Box 9600, 2333 ZA Leiden, The Netherlands
| | - Michiel A. de Graaf
- Department of Cardiology, Leiden University Medical Center, Postal Zone: C5-P, P.O. Box 9600, 2333 ZA Leiden, The Netherlands
| | - Joanne D. Schuijf
- Department of Cardiology, Leiden University Medical Center, Postal Zone: C5-P, P.O. Box 9600, 2333 ZA Leiden, The Netherlands
| | - Lucia J. Kroft
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Albert de Roos
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Johan H. C. Reiber
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeroen J. Bax
- Department of Cardiology, Leiden University Medical Center, Postal Zone: C5-P, P.O. Box 9600, 2333 ZA Leiden, The Netherlands
| | - J. Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Postal Zone: C5-P, P.O. Box 9600, 2333 ZA Leiden, The Netherlands
- The Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - Eric Boersma
- Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Martin J. Schalij
- Department of Cardiology, Leiden University Medical Center, Postal Zone: C5-P, P.O. Box 9600, 2333 ZA Leiden, The Netherlands
| | - Ernst E. van der Wall
- Department of Cardiology, Leiden University Medical Center, Postal Zone: C5-P, P.O. Box 9600, 2333 ZA Leiden, The Netherlands
- The Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
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