A three-dimensional quantification of calcified and non-calcified plaques in coronary arteries based on computed tomography coronary angiography images: Comparison with expert's annotations and virtual histology intravascular ultrasound

• Published in: Computers in biology and medicine 2019-10, Vol.113, p.103409-103409, Article 103409
• Main Authors: Kigka, Vassiliki I., Sakellarios, Antonis, Kyriakidis, Savvas, Rigas, George, Athanasiou, Lambros, Siogkas, Panagiotis, Tsompou, Panagiota, Loggitsi, Dimitra, Benz, Dominik C., Buechel, Ronny, Lemos, Pedro A., Pelosi, Gualtiero, Michalis, Lampros K., Fotiadis, Dimitrios I.
• Format: Article
• Language: English
• Subjects: Active contour models; Angiography; Annotations; Arteries; Arteriosclerosis; Atherosclerosis; Atherosclerotic plaque; Automation; Calcification; Calcified plaque; Cardiovascular disease; Computed tomography; Computed tomography coronary angiography; Coronary artery; Coronary artery disease; Coronary vessels; Correlation; Heart diseases; Histology; Image detection; Image processing; Image segmentation; Lesions; Medical imaging; Medical treatment; Non-calcified plaque; Plaques; Segmentation; Ultrasonic imaging; Ultrasound
• ISSN: 0010-4825; 1879-0534
• DOI: 10.1016/j.compbiomed.2019.103409

The detection, quantification and characterization of coronary atherosclerotic plaques has a major effect on the diagnosis and treatment of coronary artery disease (CAD). Different studies have reported and evaluated the noninvasive ability of Computed Tomography Coronary Angiography (CTCA) to identify coronary plaque features. The identification of calcified plaques (CP) and non-calcified plaques (NCP) using CTCA has been extensively studied in cardiovascular research. However, NCP detection remains a challenging problem in CTCA imaging, due to the similar intensity values of NCP compared to the perivascular tissue, which surrounds the vasculature. In this work, we present a novel methodology for the identification of the plaque burden of the coronary artery and the volumetric quantification of CP and NCP utilizing CTCA images and we compare the findings with virtual histology intravascular ultrasound (VH-IVUS) and manual expert's annotations. Bland–Altman analyses were employed to assess the agreement between the presented methodology and VH-IVUS. The assessment of the plaque volume, the lesion length and the plaque area in 18 coronary lesions indicated excellent correlation with VH-IVUS. More specifically, for the CP lesions the correlation of plaque volume, lesion length and plaque area was 0.93, 0.84 and 0.85, respectively, whereas the correlation of plaque volume, lesion length and plaque area for the NCP lesions was 0.92, 0.95 and 0.81, respectively. In addition to this, the segmentation of the lumen, CP and NCP in 1350 CTCA slices indicated that the mean value of DICE coefficient is 0.72, 0.7 and 0.62, whereas the mean HD value is 1.95, 1.74 and 1.95, for the lumen, CP and NCP, respectively. •This manuscript presents an automated methodology for the 3D reconstruction of coronary plaques using CTCA images.•The methodology is validated using VH-IVUS modality and manual expert's annotations.•The Pearson's correlation for the CP volume and NCP volume was 0.93 and 0.92, respectively.•The mean value of DICE coefficient for the lumen, CP and NCP was 0.72 ± 0.08, 0.7 ± 0.09 and 0.62 ± 0.07, respectively.