TY - JOUR
T1 - Performance of artificial intelligence in detecting the chronic total occlusive lesions of coronary artery based on coronary computed tomographic angiography
AU - Yang, Yanying
AU - Zhou, Zhen
AU - Zhang, Nan
AU - Wang, Rui
AU - Gao, Yifeng
AU - Ran, Xiaowei
AU - Sun, Zhonghua
AU - Zhang, Heye
AU - Yang, Guang
AU - Song, Xiantao
AU - Xu, Lei
N1 - Publisher Copyright:
© Cardiovascular Diagnosis and Therapy. All rights reserved.
PY - 2024/8/31
Y1 - 2024/8/31
N2 - Background: Coronary chronic total occlusion (CTO) increases the risk of developing major adverse cardiovascular events (MACE) and cardiogenic shock. Coronary computed tomography angiography (CCTA) is a safe, noninvasive method to diagnose CTO lesions. With the development of artificial intelligence (AI), AI has been broadly applied in cardiovascular images, but AI-based detection of CTO lesions from CCTA images is difficult. We aim to evaluate the performance of AI in detecting the CTO lesions of coronary arteries based on CCTA images. Methods: We retrospectively and consecutively enrolled patients with 50% stenosis, 50–99% stenosis, and CTO lesions who received CCTA scans between June 2021 and June 2022 in Beijing Anzhen Hospital. Four-fifths of them were randomly assigned to the training dataset, while the rest (1/5) were randomly assigned to the testing dataset. Performance of the AI-assisted CCTA (CCTA-AI) in detecting the CTO lesions was evaluated through sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and receiver operating characteristic analysis. With invasive coronary angiography as the reference, the diagnostic performance of AI method and manual method was compared. Results: A total of 537 patients with 1,569 stenotic lesions (including 672 lesions with <50% stenosis, 493 lesions with 50–99% stenosis, and 404 CTO lesions) were enrolled in our study. CCTA-AI saved 75% of the time in post-processing and interpreting the CCTA images when compared to the manual method (116±15 vs. 472±45 seconds). In the testing dataset, the accuracy of CCTA-AI in detecting CTO lesions was 86.2% (79.0%, 90.3%), with the area under the curve of 0.874. No significant difference was found in detecting CTO lesions between AI and manual methods (P=0.53). Conclusions: AI can automatically detect CTO lesions based on CCTA images, with high diagnostic accuracy and efficiency.
AB - Background: Coronary chronic total occlusion (CTO) increases the risk of developing major adverse cardiovascular events (MACE) and cardiogenic shock. Coronary computed tomography angiography (CCTA) is a safe, noninvasive method to diagnose CTO lesions. With the development of artificial intelligence (AI), AI has been broadly applied in cardiovascular images, but AI-based detection of CTO lesions from CCTA images is difficult. We aim to evaluate the performance of AI in detecting the CTO lesions of coronary arteries based on CCTA images. Methods: We retrospectively and consecutively enrolled patients with 50% stenosis, 50–99% stenosis, and CTO lesions who received CCTA scans between June 2021 and June 2022 in Beijing Anzhen Hospital. Four-fifths of them were randomly assigned to the training dataset, while the rest (1/5) were randomly assigned to the testing dataset. Performance of the AI-assisted CCTA (CCTA-AI) in detecting the CTO lesions was evaluated through sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and receiver operating characteristic analysis. With invasive coronary angiography as the reference, the diagnostic performance of AI method and manual method was compared. Results: A total of 537 patients with 1,569 stenotic lesions (including 672 lesions with <50% stenosis, 493 lesions with 50–99% stenosis, and 404 CTO lesions) were enrolled in our study. CCTA-AI saved 75% of the time in post-processing and interpreting the CCTA images when compared to the manual method (116±15 vs. 472±45 seconds). In the testing dataset, the accuracy of CCTA-AI in detecting CTO lesions was 86.2% (79.0%, 90.3%), with the area under the curve of 0.874. No significant difference was found in detecting CTO lesions between AI and manual methods (P=0.53). Conclusions: AI can automatically detect CTO lesions based on CCTA images, with high diagnostic accuracy and efficiency.
KW - Chronic total occlusion (CTO)
KW - artificial intelligence (AI)
KW - coronary computed tomography angiography (CCTA)
KW - diagnostic performance
UR - http://www.scopus.com/inward/record.url?scp=85202491655&partnerID=8YFLogxK
U2 - 10.21037/cdt-23-407
DO - 10.21037/cdt-23-407
M3 - Article
AN - SCOPUS:85202491655
SN - 2223-3652
VL - 14
SP - 655
EP - 667
JO - Cardiovascular Diagnosis and Therapy
JF - Cardiovascular Diagnosis and Therapy
IS - 4
ER -