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Lee HJ, Kim YW, Kim JH, Lee YJ, Moon J, Jeong P, Jeong J, Kim JS, Lee JS. Optimization of FFR prediction algorithm for gray zone by hemodynamic features with synthetic model and biometric data. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 220:106827. [PMID: 35500505 DOI: 10.1016/j.cmpb.2022.106827] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 03/31/2022] [Accepted: 04/19/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Recent attempts on adopting artificial intelligence algorithm on coronary diagnosis had limitations on data quantity and quality. While most of previous studies only used vessel image as input data, flow features and biometric features should be also considered. Moreover, the accuracy should be optimized within gray zone as the purpose is to decide stent insertion with estimated fractional flow reserve. OBJECTIVES The main purpose of this study is to develop an artificial intelligence-based coronary vascular diagnosis system focused on performance in the gray zone, from CT image extraction to FFR estimation. Three main issues should be considered for an algorithm to be used for pre-screening: algorithm optimization in the gray zone, minimization of labor during image processing, and consideration of flow and biometric features. This paper introduces a full FFR pre-screening system from automatic image extraction to an algorithm for estimating the FFR value. METHOD The main techniques used in this study are an automatic image extraction algorithm, lattice Boltzmann method based computational fluid dynamics analysis of a synthetic model and patient data, and an AI algorithm optimization. For feature extraction, this study focused on an automatic process to reduce manual labor. The algorithm consisted of two steps: the first algorithm calculates flow features from geometrical features, and the second algorithm estimates the FFR value from flow features and patient biometric features. Algorithm selection, outlier elimination, and k-fold selection were included to optimize the algorithm. CONCLUSION Eight types of algorithms including two neural network models and six machine learning models were optimized and tested. The random forest model shows the highest performance before optimization, whereas the multilayer perceptron regressor shows the highest gray zone accuracy after optimization.
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Affiliation(s)
- Hyeong Jun Lee
- School of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, Korea
| | - Young Woo Kim
- School of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, Korea
| | - Jun Hong Kim
- School of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, Korea
| | - Yong-Joon Lee
- Division of Cardiology, Severance Hospital, Yonsei University College of Medicine, Korea
| | | | | | | | - Jung-Sun Kim
- Division of Cardiology, Severance Hospital, Yonsei University College of Medicine, Korea
| | - Joon Sang Lee
- School of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, Korea.
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Wang HJ, Chen LW, Lee HY, Chung YJ, Lin YT, Lee YC, Chen YC, Chen CM, Lin MW. Automated 3D Segmentation of the Aorta and Pulmonary Artery on Non-Contrast-Enhanced Chest Computed Tomography Images in Lung Cancer Patients. Diagnostics (Basel) 2022; 12:diagnostics12040967. [PMID: 35454015 PMCID: PMC9032785 DOI: 10.3390/diagnostics12040967] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/07/2022] [Accepted: 04/09/2022] [Indexed: 12/19/2022] Open
Abstract
Pulmonary hypertension should be preoperatively evaluated for optimal surgical planning to reduce surgical risk in lung cancer patients. Preoperative measurement of vascular diameter in computed tomography (CT) images is a noninvasive prediction method for pulmonary hypertension. However, the current estimation method, 2D manual arterial diameter measurement, may yield inaccurate results owing to low tissue contrast in non-contrast-enhanced CT (NECT). Furthermore, it provides an incomplete evaluation by measuring only the diameter of the arteries rather than the volume. To provide a more complete and accurate estimation, this study proposed a novel two-stage deep learning (DL) model for 3D aortic and pulmonary artery segmentation in NECT. In the first stage, a DL model was constructed to enhance the contrast of NECT; in the second stage, two DL models then applied the enhanced images for aorta and pulmonary artery segmentation. Overall, 179 patients were divided into contrast enhancement model (n = 59), segmentation model (n = 120), and testing (n = 20) groups. The performance of the proposed model was evaluated using Dice similarity coefficient (DSC). The proposed model could achieve 0.97 ± 0.007 and 0.93 ± 0.002 DSC for aortic and pulmonary artery segmentation, respectively. The proposed model may provide 3D diameter information of the arteries before surgery, facilitating the estimation of pulmonary hypertension and supporting preoperative surgical method selection based on the predicted surgical risks.
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Affiliation(s)
- Hao-Jen Wang
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei 106, Taiwan; (H.-J.W.); (L.-W.C.); (Y.-J.C.); (Y.-T.L.); (Y.-C.C.)
| | - Li-Wei Chen
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei 106, Taiwan; (H.-J.W.); (L.-W.C.); (Y.-J.C.); (Y.-T.L.); (Y.-C.C.)
| | - Hsin-Ying Lee
- Department of Medicine, National Taiwan University, Taipei 100, Taiwan; (H.-Y.L.); (Y.-C.L.)
| | - Yu-Jung Chung
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei 106, Taiwan; (H.-J.W.); (L.-W.C.); (Y.-J.C.); (Y.-T.L.); (Y.-C.C.)
| | - Yan-Ting Lin
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei 106, Taiwan; (H.-J.W.); (L.-W.C.); (Y.-J.C.); (Y.-T.L.); (Y.-C.C.)
| | - Yi-Chieh Lee
- Department of Medicine, National Taiwan University, Taipei 100, Taiwan; (H.-Y.L.); (Y.-C.L.)
| | - Yi-Chang Chen
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei 106, Taiwan; (H.-J.W.); (L.-W.C.); (Y.-J.C.); (Y.-T.L.); (Y.-C.C.)
| | - Chung-Ming Chen
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei 106, Taiwan; (H.-J.W.); (L.-W.C.); (Y.-J.C.); (Y.-T.L.); (Y.-C.C.)
- Correspondence: (C.-M.C.); (M.-W.L.)
| | - Mong-Wei Lin
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan
- Correspondence: (C.-M.C.); (M.-W.L.)
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Sevgi DD, Srivastava SK, Whitney J, O'Connell M, Kar SS, Hu M, Reese J, Madabhushi A, Ehlers JP. Characterization of Ultra-Widefield Angiographic Vascular Features in Diabetic Retinopathy with Automated Severity Classification. OPHTHALMOLOGY SCIENCE 2022; 1. [PMID: 35224527 PMCID: PMC8870443 DOI: 10.1016/j.xops.2021.100049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Purpose To determine the association between diabetic retinopathy (DR) severity and quantitative retinal vascular features. Design Retrospective image analysis study. Participants Eyes with DR and eyes with no posterior segment disease (normal eyes) that had undergone ultra-widefield fluorescein angiography (UWFA) with associated color fundus photography. Exclusion criteria were any previous laser photocoagulation, low image quality, intravitreal or periocular pharmacotherapy within 6 months of imaging, and any other significant retinal disease including posterior uveitis, retinal vein occlusion, and choroidal neovascularization. Methods The centered early mid-phase UWFA frame that captured the maximum vessel area was selected using automated custom software for each eye. Panretinal and zonal vascular features were extracted using a machine learning algorithm. Eyes with DR were graded for DR severity as mild nonproliferative DR (NPDR), moderate NPDR, severe NPDR, and proliferative DR (PDR). Parameters of normal eyes were compared with age- and gender-matched patients with DR using the t test. Differences between severity groups were evaluated by the analysis of variance and Kruskal-Wallis tests, generalized linear mixed-effects models, and random forest regression models. Main Outcome Measures Diabetic retinopathy severity and vascular features (panretinal and zonal vessel area, length and geodesic distance, panretinal area index, tortuosity measures, vascular density measures, and zero vessel density rate). Results Ninety-seven eyes from 60 patients with DR and 12 normal eyes from 12 patients that underwent UWFA for evaluation of fellow eye pathology had images of sufficient quality to be included in this analysis. The mean age was 60 ± 10 years in DR eyes and 46 ± 17 years in normal eyes. Panretinal vessel area, mean geodesic distance, skewness, and kurtosis of local vessel density was significantly higher in normal eyes compared with the age- and gender-matched eyes with DR (P < 0.05). Zero vessel density rate, skewness of vessel density, and mean mid-peripheral geodesic distance were among the most important features for distinguishing mild NPDR from advanced forms of DR and PDR versus eyes without PDR. Conclusions Automated analysis of retinal vasculature demonstrated associations with DR severity and visual and subvisual vascular biomarkers. Further studies are needed to evaluate the clinical significance of these parameters for DR prognosis and therapeutic response.
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Affiliation(s)
- Duriye Damla Sevgi
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Sunil K Srivastava
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jon Whitney
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Margaret O'Connell
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Sudeshna Sil Kar
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.,Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Ming Hu
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.,Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jamie Reese
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Anant Madabhushi
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Justis P Ehlers
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
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Sevgi DD, Scott AW, Martin A, Mugnaini C, Patel S, Linz MO, Nti AA, Reese J, Ehlers JP. Longitudinal assessment of quantitative ultra-widefield ischaemic and vascular parameters in sickle cell retinopathy. Br J Ophthalmol 2020; 106:251-255. [PMID: 33130554 DOI: 10.1136/bjophthalmol-2020-317241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/19/2020] [Accepted: 10/06/2020] [Indexed: 11/04/2022]
Abstract
PURPOSE To evaluate longitudinal quantitative ischaemic and vasculature parameters, including ischaemic index, vessel area, length and geodesic distance in sickle cell retinopathy (SCR) on ultra-widefield fluorescein angiography (UWFA). METHODS Optimal UWFA images from two longitudinal timepoints of 74 eyes from 45 patients with SCR were aligned and a common region of interest was determined. A deep-learning augmented ischaemia and vascular segmentation platform was used for feature extraction. Geodesic distance maps demonstrating the shortest distance within the vascular masks from the centre of the optic disc were created. Ischaemic index, vessel area, vessel length and geodesic distance were measured. Paired t-test and linear mixed effect model analysis were performed. RESULTS Overall, 25 (44 eyes) patients with HbSS, 14 (19 eyes) with HbSC, 6 (11 eyes) with HbSthal and other genotypes were included. Mean age was 40.1±11.0 years. Mean time interval between two UWFA studies was 23.0±15.1 months (range: 3-71.3). Mean panretinal ischaemic index increased from 10.0±7.2% to 10.9±7.3% (p<0.005). Mean rate of change in ischaemic index was 0.5±0.7% per year. Mean vessel area (p=0.020) and geodesic distance (p=0.048) decreased significantly. Multivariate analysis demonstrated baseline ischaemic index and Goldberg stage are correlated with progression. CONCLUSION Longitudinal ischaemic index and retinal vascular parameter measurements demonstrate statistically significant progression in SCR. The clinical significance of these relatively small magnitude changes remains unclear but may provide insights into the progression of retinal ischaemia in SCR.
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Affiliation(s)
- Duriye Damla Sevgi
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Adrienne W Scott
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Alison Martin
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Christopher Mugnaini
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Shaivi Patel
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Marguerite O Linz
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Akosua A Nti
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jamie Reese
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Justis P Ehlers
- The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
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3D Segmentation Algorithms for Computerized Tomographic Imaging: a Systematic Literature Review. J Digit Imaging 2019; 31:799-850. [PMID: 29915942 DOI: 10.1007/s10278-018-0101-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
This paper presents a systematic literature review concerning 3D segmentation algorithms for computerized tomographic imaging. This analysis covers articles published in the range 2006-March 2018 found in four scientific databases (Science Direct, IEEEXplore, ACM, and PubMed), using the methodology for systematic review proposed by Kitchenham. We present the analyzed segmentation methods categorized according to its application, algorithmic strategy, validation, and use of prior knowledge, as well as its general conceptual description. Additionally, we present a general overview, discussions, and further prospects for the 3D segmentation methods applied for tomographic images.
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