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Labrecque Langlais É, Corbin D, Tastet O, Hayek A, Doolub G, Mrad S, Tardif JC, Tanguay JF, Marquis-Gravel G, Tison GH, Kadoury S, Le W, Gallo R, Lesage F, Avram R. Evaluation of stenoses using AI video models applied to coronary angiography. NPJ Digit Med 2024; 7:138. [PMID: 38783037 PMCID: PMC11116436 DOI: 10.1038/s41746-024-01134-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
The coronary angiogram is the gold standard for evaluating the severity of coronary artery disease stenoses. Presently, the assessment is conducted visually by cardiologists, a method that lacks standardization. This study introduces DeepCoro, a ground-breaking AI-driven pipeline that integrates advanced vessel tracking and a video-based Swin3D model that was trained and validated on a dataset comprised of 182,418 coronary angiography videos spanning 5 years. DeepCoro achieved a notable precision of 71.89% in identifying coronary artery segments and demonstrated a mean absolute error of 20.15% (95% CI: 19.88-20.40) and a classification AUROC of 0.8294 (95% CI: 0.8215-0.8373) in stenosis percentage prediction compared to traditional cardiologist assessments. When compared to two expert interventional cardiologists, DeepCoro achieved lower variability than the clinical reports (19.09%; 95% CI: 18.55-19.58 vs 21.00%; 95% CI: 20.20-21.76, respectively). In addition, DeepCoro can be fine-tuned to a different modality type. When fine-tuned on quantitative coronary angiography assessments, DeepCoro attained an even lower mean absolute error of 7.75% (95% CI: 7.37-8.07), underscoring the reduced variability inherent to this method. This study establishes DeepCoro as an innovative video-based, adaptable tool in coronary artery disease analysis, significantly enhancing the precision and reliability of stenosis assessment.
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Affiliation(s)
- Élodie Labrecque Langlais
- Department of Electrical Engineering, Polytechnique Montréal, Montreal, QC, Canada
- Heartwise (heartwise.ai), Montreal Heart Institute, Montreal, QC, Canada
| | - Denis Corbin
- Heartwise (heartwise.ai), Montreal Heart Institute, Montreal, QC, Canada
- Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Olivier Tastet
- Heartwise (heartwise.ai), Montreal Heart Institute, Montreal, QC, Canada
- Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Ahmad Hayek
- Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Gemina Doolub
- Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Sebastián Mrad
- Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Jean-Claude Tardif
- Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Jean-François Tanguay
- Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | | | - Geoffrey H Tison
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Samuel Kadoury
- Department of Computer Engineering, Polytechnique Montréal, Montreal, QC, Canada
| | - William Le
- Department of Computer Engineering, Polytechnique Montréal, Montreal, QC, Canada
| | - Richard Gallo
- Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Frederic Lesage
- Department of Electrical Engineering, Polytechnique Montréal, Montreal, QC, Canada
- Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Robert Avram
- Heartwise (heartwise.ai), Montreal Heart Institute, Montreal, QC, Canada.
- Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada.
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Chang SS, Lin CT, Wang WC, Hsu KC, Wu YL, Liu CH, Fann YC. Optimizing ensemble U-Net architectures for robust coronary vessel segmentation in angiographic images. Sci Rep 2024; 14:6640. [PMID: 38503839 PMCID: PMC10951254 DOI: 10.1038/s41598-024-57198-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/15/2024] [Indexed: 03/21/2024] Open
Abstract
Automated coronary angiography assessment requires precise vessel segmentation, a task complicated by uneven contrast filling and background noise. Our research introduces an ensemble U-Net model, SE-RegUNet, designed to accurately segment coronary vessels using 100 labeled angiographies from angiographic images. SE-RegUNet incorporates RegNet encoders and squeeze-and-excitation blocks to enhance feature extraction. A dual-phase image preprocessing strategy further improves the model's performance, employing unsharp masking and contrast-limited adaptive histogram equalization. Following fivefold cross-validation and Ranger21 optimization, the SE-RegUNet 4GF model emerged as the most effective, evidenced by performance metrics such as a Dice score of 0.72 and an accuracy of 0.97. Its potential for real-world application is highlighted by its ability to process images at 41.6 frames per second. External validation on the DCA1 dataset demonstrated the model's consistent robustness, achieving a Dice score of 0.76 and an accuracy of 0.97. The SE-RegUNet 4GF model's precision in segmenting blood vessels in coronary angiographies showcases its remarkable efficiency and accuracy. However, further development and clinical testing are necessary before it can be routinely implemented in medical practice.
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Affiliation(s)
- Shih-Sheng Chang
- Division of Cardiovascular Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Ching-Ting Lin
- Artificial Intelligence Center, China Medical University Hospital, Taichung, Taiwan
| | - Wei-Chun Wang
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
- Neuroscience and Brain Disease Center, China Medical University, Taichung, Taiwan
- Artificial Intelligence Center, China Medical University Hospital, Taichung, Taiwan
| | - Kai-Cheng Hsu
- Artificial Intelligence Center, China Medical University Hospital, Taichung, Taiwan
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
- Neuroscience and Brain Disease Center, China Medical University, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Ya-Lun Wu
- Artificial Intelligence Center, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Hao Liu
- Division of Cardiovascular Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yang C Fann
- Division of Intramural Research, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 35 Convent Dr., Bethesda, MD, 20892, USA.
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Ogunpola A, Saeed F, Basurra S, Albarrak AM, Qasem SN. Machine Learning-Based Predictive Models for Detection of Cardiovascular Diseases. Diagnostics (Basel) 2024; 14:144. [PMID: 38248021 PMCID: PMC10813849 DOI: 10.3390/diagnostics14020144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/21/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024] Open
Abstract
Cardiovascular diseases present a significant global health challenge that emphasizes the critical need for developing accurate and more effective detection methods. Several studies have contributed valuable insights in this field, but it is still necessary to advance the predictive models and address the gaps in the existing detection approaches. For instance, some of the previous studies have not considered the challenge of imbalanced datasets, which can lead to biased predictions, especially when the datasets include minority classes. This study's primary focus is the early detection of heart diseases, particularly myocardial infarction, using machine learning techniques. It tackles the challenge of imbalanced datasets by conducting a comprehensive literature review to identify effective strategies. Seven machine learning and deep learning classifiers, including K-Nearest Neighbors, Support Vector Machine, Logistic Regression, Convolutional Neural Network, Gradient Boost, XGBoost, and Random Forest, were deployed to enhance the accuracy of heart disease predictions. The research explores different classifiers and their performance, providing valuable insights for developing robust prediction models for myocardial infarction. The study's outcomes emphasize the effectiveness of meticulously fine-tuning an XGBoost model for cardiovascular diseases. This optimization yields remarkable results: 98.50% accuracy, 99.14% precision, 98.29% recall, and a 98.71% F1 score. Such optimization significantly enhances the model's diagnostic accuracy for heart disease.
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Affiliation(s)
- Adedayo Ogunpola
- DAAI Research Group, College of Computing and Digital Technology, Birmingham City University, Birmingham B4 7XG, UK; (A.O.); (S.B.)
| | - Faisal Saeed
- DAAI Research Group, College of Computing and Digital Technology, Birmingham City University, Birmingham B4 7XG, UK; (A.O.); (S.B.)
| | - Shadi Basurra
- DAAI Research Group, College of Computing and Digital Technology, Birmingham City University, Birmingham B4 7XG, UK; (A.O.); (S.B.)
| | - Abdullah M. Albarrak
- Computer Science Department, College of Computer and Information Sciences, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 11432, Saudi Arabia; (A.M.A.); (S.N.Q.)
| | - Sultan Noman Qasem
- Computer Science Department, College of Computer and Information Sciences, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 11432, Saudi Arabia; (A.M.A.); (S.N.Q.)
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Wu H, Zhao J, Li J, Zeng Y, Wu W, Zhou Z, Wu S, Xu L, Song M, Yu Q, Song Z, Chen L. One-Stage Detection without Segmentation for Multi-Type Coronary Lesions in Angiography Images Using Deep Learning. Diagnostics (Basel) 2023; 13:3011. [PMID: 37761378 PMCID: PMC10528585 DOI: 10.3390/diagnostics13183011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
It is rare to use the one-stage model without segmentation for the automatic detection of coronary lesions. This study sequentially enrolled 200 patients with significant stenoses and occlusions of the right coronary and categorized their angiography images into two angle views: The CRA (cranial) view of 98 patients with 2453 images and the LAO (left anterior oblique) view of 176 patients with 3338 images. Randomization was performed at the patient level to the training set and test set using a 7:3 ratio. YOLOv5 was adopted as the key model for direct detection. Four types of lesions were studied: Local Stenosis (LS), Diffuse Stenosis (DS), Bifurcation Stenosis (BS), and Chronic Total Occlusion (CTO). At the image level, the precision, recall, mAP@0.1, and mAP@0.5 predicted by the model were 0.64, 0.68, 0.66, and 0.49 in the CRA view and 0.68, 0.73, 0.70, and 0.56 in the LAO view, respectively. At the patient level, the precision, recall, and F1scores predicted by the model were 0.52, 0.91, and 0.65 in the CRA view and 0.50, 0.94, and 0.64 in the LAO view, respectively. YOLOv5 performed the best for lesions of CTO and LS at both the image level and the patient level. In conclusion, the one-stage model without segmentation as YOLOv5 is feasible to be used in automatic coronary lesion detection, with the most suitable types of lesions as LS and CTO.
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Affiliation(s)
- Hui Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Jing Zhao
- Department of Geriatrics, The Third Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - Jiehui Li
- State Key Laboratory of Cardiovascular Disease, Department of Cardiac Surgery, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Yan Zeng
- Department of Research Center, Shanghai United Imaging Intelligence Co., Ltd., Shanghai 201807, China
| | - Weiwei Wu
- College of Biomedical Engineering, Capital Medical University, Beijing 100069, China
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Shuicai Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Liang Xu
- State Key Laboratory of Cardiovascular Disease, Department of Structural Heart Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Min Song
- State Key Laboratory of Cardiovascular Disease, Department of Cardiac Surgery, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Qibin Yu
- State Key Laboratory of Cardiovascular Disease, Department of Cardiac Surgery, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Ziwei Song
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Lin Chen
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
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