Cited by 321Cardiac Imaging and DiagnosticsMedical Image Segmentation TechniquesMedical Imaging and Analysis

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Automatic coronary artery calcium scoring in cardiac CT angiography using paired convolutional neural networks

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Wolterink, Jelmer M., Leiner, Tim, de Vos, Bob D., van Hamersvelt, Robbert W., Viergever, Max A., Išgum, Ivana·2016·Medical Image Analysis

DOI 10.1016/j.media.2016.04.004

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Abstract

The amount of coronary artery calcification (CAC) is a strong and independent predictor of cardiovascular events. CAC is clinically quantified in cardiac calcium scoring CT (CSCT), but it has been shown that cardiac CT angiography (CCTA) may also be used for this purpose. We present a method for automatic CAC quantification in CCTA. This method uses supervised learning to directly identify and quantify CAC without a need for coronary artery extraction commonly used in existing methods. The study included cardiac CT exams of 250 patients for whom both a CCTA and a CSCT scan were available. To restrict the volume-of-interest for analysis, a bounding box around the heart is automatically determined. The bounding box detection algorithm employs a combination of three ConvNets, where each detects the heart in a different orthogonal plane (axial, sagittal, coronal). These ConvNets were trained using 50 cardiac CT exams. In the remaining 200 exams, a reference standard for CAC was defined in CSCT and CCTA. Out of these, 100 CCTA scans were used for training, and the remaining 100 for evaluation of a voxel classification method for CAC identification. The method uses ConvPairs, pairs of convolutional neural networks (ConvNets). The first ConvNet in a pair identifies voxels likely to be CAC, thereby discarding the majority of non-CAC-like voxels such as lung and fatty tissue. The identified CAC-like voxels are further classified by the second ConvNet in the pair, which distinguishes b…

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Authors: Wolterink, J. M., Leiner, T., de Vos, B. D., van Hamersvelt, R. W., Viergever, M. A., & Išgum, I.
Affiliations: University Medical Center Utrecht (NL)
Corresponding author: Wolterink, Jelmer M.
ORCID: Wolterink, Jelmer M.
Leiner, Tim
de Vos, Bob D.
van Hamersvelt, Robbert W.
Viergever, Max A.
Išgum, Ivana
Venue: Medical Image Analysis
Publisher: Elsevier BV
Published: 2016-12
Volume: 34
Pages: 123-136
ISSN: 1361-8415 (ISSN-L)
DOI: 10.1016/j.media.2016.04.004
OpenAlex: W2345003174
Cited by: 321
References: 64
Citations by year: 2026: 16 · 2025: 23 · 2024: 36 · 2023: 34 · 2022: 40 · 2021: 41 · 2020: 45 · 2019: 38 · 2018: 28 · 2017: 17 · 2016: 3
FWCI: 24.89
Type: journal article
Language: en
Open access: green
dspace.library.uu.nl
Licence: other-oa
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Medical Image Analysis (publishedVersion)
PubMed (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
Pure Amsterdam UMC (submittedVersion)
Utrecht University Repository (Utrecht University) (submittedVersion)
Funders: Nvidia
ZonMw
Topics: Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Medical Image Segmentation Techniques
Physical Sciences › Engineering › Biomedical Engineering › Medical Imaging and Analysis
Keywords: coronary artery calcification, cardiac CT angiography, coronary artery calcium scoring, voxel classification, ensemble learning, cardiovascular risk prediction, coronary artery disease screening, false positive reduction
MeSH terms: Computed Tomography Angiography, Algorithms, Calcium, Coronary Artery Disease, Humans, Risk Factors, Sensitivity and Specificity, Reproducibility of Results, Neural Networks, Computer

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Automatic coronary artery calcium scoring in cardiac CT angiography using paired convolutional neural networks

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