Artificial Intelligence (Enhanced Super-Resolution Generative Adversarial Network) for Calcium Deblooming in Coronary Computed Tomography Angiography: A Feasibility Study

Background: The presence of heavy calcification in the coronary artery always presents a challenge for coronary computed tomography angiography (CCTA) in assessing the degree of coronary stenosis due to blooming artifacts associated with calcified plaques. Our study purpose was to use an advanced ar...

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Main Authors: Zhonghua Sun, Curtise K. C. Ng
Format: Article
Language:English
Published: MDPI AG 2022-04-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/12/4/991
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author Zhonghua Sun
Curtise K. C. Ng
author_facet Zhonghua Sun
Curtise K. C. Ng
author_sort Zhonghua Sun
collection DOAJ
description Background: The presence of heavy calcification in the coronary artery always presents a challenge for coronary computed tomography angiography (CCTA) in assessing the degree of coronary stenosis due to blooming artifacts associated with calcified plaques. Our study purpose was to use an advanced artificial intelligence (enhanced super-resolution generative adversarial network [ESRGAN]) model to suppress the blooming artifact in CCTA and determine its effect on improving the diagnostic performance of CCTA in calcified plaques. Methods: A total of 184 calcified plaques from 50 patients who underwent both CCTA and invasive coronary angiography (ICA) were analysed with measurements of coronary lumen on the original CCTA, and three sets of ESRGAN-processed images including ESRGAN-high-resolution (ESRGAN-HR), ESRGAN-average and ESRGAN-median with ICA as the reference method for determining sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results: ESRGAN-processed images improved the specificity and PPV at all three coronary arteries (LAD-left anterior descending, LCx-left circumflex and RCA-right coronary artery) compared to original CCTA with ESRGAN-median resulting in the highest values being 41.0% (95% confidence interval [CI]: 30%, 52.7%) and 26.9% (95% CI: 22.9%, 31.4%) at LAD; 41.7% (95% CI: 22.1%, 63.4%) and 36.4% (95% CI: 28.9%, 44.5%) at LCx; 55% (95% CI: 38.5%, 70.7%) and 47.1% (95% CI: 38.7%, 55.6%) at RCA; while corresponding values for original CCTA were 21.8% (95% CI: 13.2%, 32.6%) and 22.8% (95% CI: 20.8%, 24.9%); 12.5% (95% CI: 2.6%, 32.4%) and 27.6% (95% CI: 24.7%, 30.7%); 17.5% (95% CI: 7.3%, 32.8%) and 32.7% (95% CI: 29.6%, 35.9%) at LAD, LCx and RCA, respectively. There was no significant effect on sensitivity and NPV between the original CCTA and ESRGAN-processed images at all three coronary arteries. The area under the receiver operating characteristic curve was the highest with ESRGAN-median images at the RCA level with values being 0.76 (95% CI: 0.64, 0.89), 0.81 (95% CI: 0.69, 0.93), 0.82 (95% CI: 0.71, 0.94) and 0.86 (95% CI: 0.76, 0.96) corresponding to original CCTA and ESRGAN-HR, average and median images, respectively. Conclusions: This feasibility study shows the potential value of ESRGAN-processed images in improving the diagnostic value of CCTA for patients with calcified plaques.
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spelling doaj.art-2f46502ce4dc4f4ea091727bd9a886772023-12-01T01:35:16ZengMDPI AGDiagnostics2075-44182022-04-0112499110.3390/diagnostics12040991Artificial Intelligence (Enhanced Super-Resolution Generative Adversarial Network) for Calcium Deblooming in Coronary Computed Tomography Angiography: A Feasibility StudyZhonghua Sun0Curtise K. C. Ng1Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, P.O. Box U1987, Perth, WA 6845, AustraliaDiscipline of Medical Radiation Science, Curtin Medical School, Curtin University, P.O. Box U1987, Perth, WA 6845, AustraliaBackground: The presence of heavy calcification in the coronary artery always presents a challenge for coronary computed tomography angiography (CCTA) in assessing the degree of coronary stenosis due to blooming artifacts associated with calcified plaques. Our study purpose was to use an advanced artificial intelligence (enhanced super-resolution generative adversarial network [ESRGAN]) model to suppress the blooming artifact in CCTA and determine its effect on improving the diagnostic performance of CCTA in calcified plaques. Methods: A total of 184 calcified plaques from 50 patients who underwent both CCTA and invasive coronary angiography (ICA) were analysed with measurements of coronary lumen on the original CCTA, and three sets of ESRGAN-processed images including ESRGAN-high-resolution (ESRGAN-HR), ESRGAN-average and ESRGAN-median with ICA as the reference method for determining sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results: ESRGAN-processed images improved the specificity and PPV at all three coronary arteries (LAD-left anterior descending, LCx-left circumflex and RCA-right coronary artery) compared to original CCTA with ESRGAN-median resulting in the highest values being 41.0% (95% confidence interval [CI]: 30%, 52.7%) and 26.9% (95% CI: 22.9%, 31.4%) at LAD; 41.7% (95% CI: 22.1%, 63.4%) and 36.4% (95% CI: 28.9%, 44.5%) at LCx; 55% (95% CI: 38.5%, 70.7%) and 47.1% (95% CI: 38.7%, 55.6%) at RCA; while corresponding values for original CCTA were 21.8% (95% CI: 13.2%, 32.6%) and 22.8% (95% CI: 20.8%, 24.9%); 12.5% (95% CI: 2.6%, 32.4%) and 27.6% (95% CI: 24.7%, 30.7%); 17.5% (95% CI: 7.3%, 32.8%) and 32.7% (95% CI: 29.6%, 35.9%) at LAD, LCx and RCA, respectively. There was no significant effect on sensitivity and NPV between the original CCTA and ESRGAN-processed images at all three coronary arteries. The area under the receiver operating characteristic curve was the highest with ESRGAN-median images at the RCA level with values being 0.76 (95% CI: 0.64, 0.89), 0.81 (95% CI: 0.69, 0.93), 0.82 (95% CI: 0.71, 0.94) and 0.86 (95% CI: 0.76, 0.96) corresponding to original CCTA and ESRGAN-HR, average and median images, respectively. Conclusions: This feasibility study shows the potential value of ESRGAN-processed images in improving the diagnostic value of CCTA for patients with calcified plaques.https://www.mdpi.com/2075-4418/12/4/991assessmentcalcificationcardiac computed tomographycoronary artery diseasedeep learningmodel
spellingShingle Zhonghua Sun
Curtise K. C. Ng
Artificial Intelligence (Enhanced Super-Resolution Generative Adversarial Network) for Calcium Deblooming in Coronary Computed Tomography Angiography: A Feasibility Study
Diagnostics
assessment
calcification
cardiac computed tomography
coronary artery disease
deep learning
model
title Artificial Intelligence (Enhanced Super-Resolution Generative Adversarial Network) for Calcium Deblooming in Coronary Computed Tomography Angiography: A Feasibility Study
title_full Artificial Intelligence (Enhanced Super-Resolution Generative Adversarial Network) for Calcium Deblooming in Coronary Computed Tomography Angiography: A Feasibility Study
title_fullStr Artificial Intelligence (Enhanced Super-Resolution Generative Adversarial Network) for Calcium Deblooming in Coronary Computed Tomography Angiography: A Feasibility Study
title_full_unstemmed Artificial Intelligence (Enhanced Super-Resolution Generative Adversarial Network) for Calcium Deblooming in Coronary Computed Tomography Angiography: A Feasibility Study
title_short Artificial Intelligence (Enhanced Super-Resolution Generative Adversarial Network) for Calcium Deblooming in Coronary Computed Tomography Angiography: A Feasibility Study
title_sort artificial intelligence enhanced super resolution generative adversarial network for calcium deblooming in coronary computed tomography angiography a feasibility study
topic assessment
calcification
cardiac computed tomography
coronary artery disease
deep learning
model
url https://www.mdpi.com/2075-4418/12/4/991
work_keys_str_mv AT zhonghuasun artificialintelligenceenhancedsuperresolutiongenerativeadversarialnetworkforcalciumdebloomingincoronarycomputedtomographyangiographyafeasibilitystudy
AT curtisekcng artificialintelligenceenhancedsuperresolutiongenerativeadversarialnetworkforcalciumdebloomingincoronarycomputedtomographyangiographyafeasibilitystudy