Performance of artificial intelligence in detecting the chronic total occlusive lesions of coronary artery based on coronary computed tomographic angiography
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 intelligen...
| Main Authors: | , , , , , , , , , , |
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| Format: | Journal Article |
| Published: |
AME Publishing Company
2024
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| Online Access: | http://hdl.handle.net/20.500.11937/95381 |
| _version_ | 1848766004585299968 |
|---|---|
| author | Yang, Y. Zhou, Z. Zhang, N. Wang, R. Gao, Y. Ran, X. Sun, Zhonghua Zhang, H. Yang, G. Song, Y. Xu, L. |
| author_facet | Yang, Y. Zhou, Z. Zhang, N. Wang, R. Gao, Y. Ran, X. Sun, Zhonghua Zhang, H. Yang, G. Song, Y. Xu, L. |
| author_sort | Yang, Y. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T11:44:15Z |
| format | Journal Article |
| id | curtin-20.500.11937-95381 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T11:44:15Z |
| publishDate | 2024 |
| publisher | AME Publishing Company |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-953812024-08-23T01:28:27Z Performance of artificial intelligence in detecting the chronic total occlusive lesions of coronary artery based on coronary computed tomographic angiography Yang, Y. Zhou, Z. Zhang, N. Wang, R. Gao, Y. Ran, X. Sun, Zhonghua Zhang, H. Yang, G. Song, Y. Xu, L. 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. 2024 Journal Article http://hdl.handle.net/20.500.11937/95381 10.21037/cdt-23-407 http://creativecommons.org/licenses/by-nc-nd/4.0/ AME Publishing Company fulltext |
| spellingShingle | Yang, Y. Zhou, Z. Zhang, N. Wang, R. Gao, Y. Ran, X. Sun, Zhonghua Zhang, H. Yang, G. Song, Y. Xu, L. Performance of artificial intelligence in detecting the chronic total occlusive lesions of coronary artery based on coronary computed tomographic angiography |
| title | Performance of artificial intelligence in detecting the chronic total occlusive lesions of coronary artery based on coronary computed tomographic angiography |
| title_full | Performance of artificial intelligence in detecting the chronic total occlusive lesions of coronary artery based on coronary computed tomographic angiography |
| title_fullStr | Performance of artificial intelligence in detecting the chronic total occlusive lesions of coronary artery based on coronary computed tomographic angiography |
| title_full_unstemmed | Performance of artificial intelligence in detecting the chronic total occlusive lesions of coronary artery based on coronary computed tomographic angiography |
| title_short | Performance of artificial intelligence in detecting the chronic total occlusive lesions of coronary artery based on coronary computed tomographic angiography |
| title_sort | performance of artificial intelligence in detecting the chronic total occlusive lesions of coronary artery based on coronary computed tomographic angiography |
| url | http://hdl.handle.net/20.500.11937/95381 |