Real-time coronary artery stenosis detection based on modern neural networks

Invasive coronary angiography remains the gold standard for diagnosing coronary artery disease, which may be complicated by both, patient-specific anatomy and image quality. Deep learning techniques aimed at detecting coronary artery stenoses may facilitate the diagnosis. However, previous studies have failed to achieve superior accuracy and performance for real-time labeling. Our study is aimed at confirming the feasibility of real-time coronary artery stenosis detection using deep learning methods. To reach this goal we trained and tested eight promising detectors based on different neural network architectures (MobileNet, ResNet-50, ResNet-101, Inception ResNet, NASNet) using clinical angiography data of 100 patients. Three neural networks have demonstrated superior results. The network based on Faster-RCNN Inception ResNet V2 is the most accurate and it achieved the mean Average Precision of 0.95, F1-score 0.96 and the slowest prediction rate of 3 fps on the validation subset. The relatively lightweight SSD MobileNet V2 network proved itself as the fastest one with a low mAP of 0.83, F1-score of 0.80 and a mean prediction rate of 38 fps. The model based on RFCN ResNet-101 V2 has demonstrated an optimal accuracy-to-speed ratio. Its mAP makes up 0.94, F1-score 0.96 while the prediction speed is 10 fps. The resultant performance-accuracy balance of the modern neural networks has confirmed the feasibility of real-time coronary artery stenosis detection supporting the decision-making process of the Heart Team interpreting coronary angiography findings

Hybrid System of Tiered Multivariate Analysis and Artificial Neural Network for Coronary Heart Disease Diagnosis

Improved system performance diagnosis of coronary heart disease becomes an important topic in research for several decades. One improvement would be done by features selection, so only the attributes that influence is used in the diagnosis system using data mining algorithms. Unfortunately, the most feature selection is done with the assumption has provided all the necessary attributes, regardless of the stage of obtaining the attribute, and cost required. This research proposes a hybrid model system for diagnosis of coronary heart disease. System diagnosis preceded the feature selection process, using tiered multivariate analysis. The analytical method used is logistic regression. The next stage, the classification by using multi-layer perceptron neural network. Based on test results, system performance proposed value for accuracy 86.3%, sensitivity 84.80%, specificity 88.20%, positive prediction value (PPV) 90.03%, negative prediction value (NPV) 81.80%, accuracy 86,30%  and area under the curve (AUC) of 92.1%. The performance of a diagnosis using a combination attributes of risk factors,symptoms and exercise ECG. The conclusion that can be drawn is that the proposed diagnosis system capable of delivering performance in the very good category, with a number of attributes that are not a lot of checks and a relatively low cost

Deep Learning in Cardiology

The medical field is creating large amount of data that physicians are unable to decipher and use efficiently. Moreover, rule-based expert systems are inefficient in solving complicated medical tasks or for creating insights using big data. Deep learning has emerged as a more accurate and effective technology in a wide range of medical problems such as diagnosis, prediction and intervention. Deep learning is a representation learning method that consists of layers that transform the data non-linearly, thus, revealing hierarchical relationships and structures. In this review we survey deep learning application papers that use structured data, signal and imaging modalities from cardiology. We discuss the advantages and limitations of applying deep learning in cardiology that also apply in medicine in general, while proposing certain directions as the most viable for clinical use.Comment: 27 pages, 2 figures, 10 table

A Comparison of Patient History- and EKG-based Cardiac Risk Scores.

Patient-specific risk scores are used to identify individuals at elevated risk for cardiovascular disease. Typically, risk scores are based on patient habits and medical history - age, sex, race, smoking behavior, and prior vital signs and diagnoses. We explore an alternative source of information, a patient's raw electrocardiogram recording, and develop a score of patient risk for various outcomes. We compare models that predict adverse cardiac outcomes following an emergency department visit, and show that a learned representation (e.g. deep neural network) of raw EKG waveforms can improve prediction over traditional risk factors. Further, we show that a simple model based on segmented heart beats performs as well or better than a complex convolutional network recently shown to reliably automate arrhythmia detection in EKGs. We analyze a large cohort of emergency department patients and show evidence that EKG-derived scores can be more robust to patient heterogeneity

An automatic deep learning approach for coronary artery calcium segmentation

Coronary artery calcium (CAC) is a significant marker of atherosclerosis and cardiovascular events. In this work we present a system for the automatic quantification of calcium score in ECG-triggered non-contrast enhanced cardiac computed tomography (CT) images. The proposed system uses a supervised deep learning algorithm, i.e. convolutional neural network (CNN) for the segmentation and classification of candidate lesions as coronary or not, previously extracted in the region of the heart using a cardiac atlas. We trained our network with 45 CT volumes; 18 volumes were used to validate the model and 56 to test it. Individual lesions were detected with a sensitivity of 91.24%, a specificity of 95.37% and a positive predicted value (PPV) of 90.5%; comparing calcium score obtained by the system and calcium score manually evaluated by an expert operator, a Pearson coefficient of 0.983 was obtained. A high agreement (Cohen's k = 0.879) between manual and automatic risk prediction was also observed. These results demonstrated that convolutional neural networks can be effectively applied for the automatic segmentation and classification of coronary calcifications