Background Coronary artery calcification is a well-known marker of atherosclerotic plaque burden.High-resolution intravascular optical coherence tomography(OCT)imaging has shown the potential to characterize the detai...Background Coronary artery calcification is a well-known marker of atherosclerotic plaque burden.High-resolution intravascular optical coherence tomography(OCT)imaging has shown the potential to characterize the details of coronary calcification in vivo.In routine clinical practice,it is a time-consuming and laborious task for clinicians to review the over 250 images in a single pullback.Besides,the imbalance label distribution within the entire pullbacks is another problem,which could lead to the failure of the classifier model.Given the success of deep learning methods with other imaging modalities,a thorough understanding of calcified plaque detection using Convolutional Neural Networks(CNNs)within pullbacks for future clinical decision was required.Methods All 33 IVOCT clinical pullbacks of 33 patients were taken from Affiliated Drum Tower Hospital,Nanjing University between December 2017 and December 2018.For ground-truth annotation,three trained experts determined the type of plaque that was present in a B-Scan.The experts assigned the labels'no calcified plaque','calcified plaque'for each OCT image.All experts were provided the all images for labeling.The final label was determined based on consensus between the experts,different opinions on the plaque type were resolved by asking the experts for a repetition of their evaluation.Before the implement of algorithm,all OCT images was resized to a resolution of 300×300,which matched the range used with standard architectures in the natural image domain.In the study,we randomly selected 26 pullbacks for training,the remaining data were testing.While,imbalance label distribution within entire pullbacks was great challenge for various CNNs architecture.In order to resolve the problem,we designed the following experiment.First,we fine-tuned twenty different CNNs architecture,including customize CNN architectures and pretrained CNN architectures.Considering the nature of OCT images,customize CNN architectures were designed that the layers were fewer than 25 layers.Then,three with good performance were selected and further deep fine-tuned to train three different models.The difference of CNNs was mainly in the model architecture,such as depth-based residual networks,width-based inception networks.Finally,the three CNN models were used to majority voting,the predicted labels were from the most voting.Areas under the receiver operating characteristic curve(ROC AUC)were used as the evaluation metric for the imbalance label distribution.Results The imbalance label distribution within pullbacks affected both convergence during the training phase and generalization of a CNN model.Different labels of OCT images could be classified with excellent performance by fine tuning parameters of CNN architectures.Overall,we find that our final result performed best with an accuracy of 90%of'calcified plaque'class,which the numbers were less than'no calcified plaque'class in one pullback.Conclusions The obtained results showed that the method is fast and effective to classify calcific plaques with imbalance label distribution in each pullback.The results suggest that the proposed method could be facilitating our understanding of coronary artery calcification in the process of atherosclerosis andhelping guide complex interventional strategies in coronary arteries with superficial calcification.展开更多
基金supported in part by the National Natural Science Foundation of China ( NSFC ) ( 11772093)ARC ( FT140101152)
文摘Background Coronary artery calcification is a well-known marker of atherosclerotic plaque burden.High-resolution intravascular optical coherence tomography(OCT)imaging has shown the potential to characterize the details of coronary calcification in vivo.In routine clinical practice,it is a time-consuming and laborious task for clinicians to review the over 250 images in a single pullback.Besides,the imbalance label distribution within the entire pullbacks is another problem,which could lead to the failure of the classifier model.Given the success of deep learning methods with other imaging modalities,a thorough understanding of calcified plaque detection using Convolutional Neural Networks(CNNs)within pullbacks for future clinical decision was required.Methods All 33 IVOCT clinical pullbacks of 33 patients were taken from Affiliated Drum Tower Hospital,Nanjing University between December 2017 and December 2018.For ground-truth annotation,three trained experts determined the type of plaque that was present in a B-Scan.The experts assigned the labels'no calcified plaque','calcified plaque'for each OCT image.All experts were provided the all images for labeling.The final label was determined based on consensus between the experts,different opinions on the plaque type were resolved by asking the experts for a repetition of their evaluation.Before the implement of algorithm,all OCT images was resized to a resolution of 300×300,which matched the range used with standard architectures in the natural image domain.In the study,we randomly selected 26 pullbacks for training,the remaining data were testing.While,imbalance label distribution within entire pullbacks was great challenge for various CNNs architecture.In order to resolve the problem,we designed the following experiment.First,we fine-tuned twenty different CNNs architecture,including customize CNN architectures and pretrained CNN architectures.Considering the nature of OCT images,customize CNN architectures were designed that the layers were fewer than 25 layers.Then,three with good performance were selected and further deep fine-tuned to train three different models.The difference of CNNs was mainly in the model architecture,such as depth-based residual networks,width-based inception networks.Finally,the three CNN models were used to majority voting,the predicted labels were from the most voting.Areas under the receiver operating characteristic curve(ROC AUC)were used as the evaluation metric for the imbalance label distribution.Results The imbalance label distribution within pullbacks affected both convergence during the training phase and generalization of a CNN model.Different labels of OCT images could be classified with excellent performance by fine tuning parameters of CNN architectures.Overall,we find that our final result performed best with an accuracy of 90%of'calcified plaque'class,which the numbers were less than'no calcified plaque'class in one pullback.Conclusions The obtained results showed that the method is fast and effective to classify calcific plaques with imbalance label distribution in each pullback.The results suggest that the proposed method could be facilitating our understanding of coronary artery calcification in the process of atherosclerosis andhelping guide complex interventional strategies in coronary arteries with superficial calcification.
