Reproducibility and repeatability of coronary computed tomography angiography (CCTA) image segmentation in detecting atherosclerosis: a radiomics study
Atherosclerosis is known as the leading factor in heart disease with the highest mortality rate among the Malaysian population. Usually, the gold standard for diagnosing atherosclerosis is by using the coronary computed tomography angiography (CCTA) technique to look for plaque within the coronary a...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Published: |
MDPI
2022
|
| Online Access: | http://psasir.upm.edu.my/id/eprint/103057/ |
| _version_ | 1848863928215404544 |
|---|---|
| author | Mohd Yunus, Mardhiyati Sabarudin, Akmal Abdul Karim, Muhammad Khalis Nohuddin, Puteri N. E. Zainal, Isa Azzaki Mohd Shamsul, Mohd Shahril Mohamed Yusof, Ahmad Khairuddin |
| author_facet | Mohd Yunus, Mardhiyati Sabarudin, Akmal Abdul Karim, Muhammad Khalis Nohuddin, Puteri N. E. Zainal, Isa Azzaki Mohd Shamsul, Mohd Shahril Mohamed Yusof, Ahmad Khairuddin |
| author_sort | Mohd Yunus, Mardhiyati |
| building | UPM Institutional Repository |
| collection | Online Access |
| description | Atherosclerosis is known as the leading factor in heart disease with the highest mortality rate among the Malaysian population. Usually, the gold standard for diagnosing atherosclerosis is by using the coronary computed tomography angiography (CCTA) technique to look for plaque within the coronary artery. However, qualitative diagnosis for noncalcified atherosclerosis is vulnerable to false-positive diagnoses, as well as inconsistent reporting between observers. In this study, we assess the reproducibility and repeatability of segmenting atherosclerotic lesions manually and semiautomatically in CCTA images to identify the most appropriate CCTA image segmentation method for radiomics analysis to quantitatively extract the atherosclerotic lesion. Thirty (30) CCTA images were taken retrospectively from the radiology image database of Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur, Malaysia. We extract 11,700 radiomics features which include the first-order, second-order and shape features from 180 times of image segmentation. The interest vessels were segmentized manually and semiautomatically using LIFEx (Version 7.0.15, Institut Curie, Orsay, France) software by two independent radiology experts, focusing on three main coronary blood vessels. As a result, manual segmentation with a soft-tissuewindowing setting yielded higher repeatability as compared to semiautomatic segmentation with a significant intraclass correlation coefficient (intra-CC) 0.961 for thefirst-order and shape features; intra-CC of 0.924 for thesecond-order features with p < 0.001. Meanwhile, the semiautomatic segmentation has higher reproducibility as compared to manual segmentation with significant interclass correlation coefficient (inter-CC) of 0.920 (first-order features) and a good interclass correlation coefficient of 0.839 for the second-order features with p < 0.001. The first-order, shape order and second-order features for both manual and semiautomatic segmentation have an excellent percentage of reproducibility and repeatability (intra-CC > 0.9). In conclusion, semi-automated segmentation is recommended for inter-observer study while manual segmentation with soft tissue-windowing can be used for single observer study. |
| first_indexed | 2025-11-15T13:40:42Z |
| format | Article |
| id | upm-103057 |
| institution | Universiti Putra Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-15T13:40:42Z |
| publishDate | 2022 |
| publisher | MDPI |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | upm-1030572024-06-23T01:18:05Z http://psasir.upm.edu.my/id/eprint/103057/ Reproducibility and repeatability of coronary computed tomography angiography (CCTA) image segmentation in detecting atherosclerosis: a radiomics study Mohd Yunus, Mardhiyati Sabarudin, Akmal Abdul Karim, Muhammad Khalis Nohuddin, Puteri N. E. Zainal, Isa Azzaki Mohd Shamsul, Mohd Shahril Mohamed Yusof, Ahmad Khairuddin Atherosclerosis is known as the leading factor in heart disease with the highest mortality rate among the Malaysian population. Usually, the gold standard for diagnosing atherosclerosis is by using the coronary computed tomography angiography (CCTA) technique to look for plaque within the coronary artery. However, qualitative diagnosis for noncalcified atherosclerosis is vulnerable to false-positive diagnoses, as well as inconsistent reporting between observers. In this study, we assess the reproducibility and repeatability of segmenting atherosclerotic lesions manually and semiautomatically in CCTA images to identify the most appropriate CCTA image segmentation method for radiomics analysis to quantitatively extract the atherosclerotic lesion. Thirty (30) CCTA images were taken retrospectively from the radiology image database of Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur, Malaysia. We extract 11,700 radiomics features which include the first-order, second-order and shape features from 180 times of image segmentation. The interest vessels were segmentized manually and semiautomatically using LIFEx (Version 7.0.15, Institut Curie, Orsay, France) software by two independent radiology experts, focusing on three main coronary blood vessels. As a result, manual segmentation with a soft-tissuewindowing setting yielded higher repeatability as compared to semiautomatic segmentation with a significant intraclass correlation coefficient (intra-CC) 0.961 for thefirst-order and shape features; intra-CC of 0.924 for thesecond-order features with p < 0.001. Meanwhile, the semiautomatic segmentation has higher reproducibility as compared to manual segmentation with significant interclass correlation coefficient (inter-CC) of 0.920 (first-order features) and a good interclass correlation coefficient of 0.839 for the second-order features with p < 0.001. The first-order, shape order and second-order features for both manual and semiautomatic segmentation have an excellent percentage of reproducibility and repeatability (intra-CC > 0.9). In conclusion, semi-automated segmentation is recommended for inter-observer study while manual segmentation with soft tissue-windowing can be used for single observer study. MDPI 2022 Article PeerReviewed Mohd Yunus, Mardhiyati and Sabarudin, Akmal and Abdul Karim, Muhammad Khalis and Nohuddin, Puteri N. E. and Zainal, Isa Azzaki and Mohd Shamsul, Mohd Shahril and Mohamed Yusof, Ahmad Khairuddin (2022) Reproducibility and repeatability of coronary computed tomography angiography (CCTA) image segmentation in detecting atherosclerosis: a radiomics study. Diagnostics, 12 (8). art. no. 2007. pp. 1-17. ISSN 2075-4418 https://www.mdpi.com/2075-4418/12/8/2007 10.3390/diagnostics12082007 |
| spellingShingle | Mohd Yunus, Mardhiyati Sabarudin, Akmal Abdul Karim, Muhammad Khalis Nohuddin, Puteri N. E. Zainal, Isa Azzaki Mohd Shamsul, Mohd Shahril Mohamed Yusof, Ahmad Khairuddin Reproducibility and repeatability of coronary computed tomography angiography (CCTA) image segmentation in detecting atherosclerosis: a radiomics study |
| title | Reproducibility and repeatability of coronary computed tomography angiography (CCTA) image segmentation in detecting atherosclerosis: a radiomics study |
| title_full | Reproducibility and repeatability of coronary computed tomography angiography (CCTA) image segmentation in detecting atherosclerosis: a radiomics study |
| title_fullStr | Reproducibility and repeatability of coronary computed tomography angiography (CCTA) image segmentation in detecting atherosclerosis: a radiomics study |
| title_full_unstemmed | Reproducibility and repeatability of coronary computed tomography angiography (CCTA) image segmentation in detecting atherosclerosis: a radiomics study |
| title_short | Reproducibility and repeatability of coronary computed tomography angiography (CCTA) image segmentation in detecting atherosclerosis: a radiomics study |
| title_sort | reproducibility and repeatability of coronary computed tomography angiography (ccta) image segmentation in detecting atherosclerosis: a radiomics study |
| url | http://psasir.upm.edu.my/id/eprint/103057/ http://psasir.upm.edu.my/id/eprint/103057/ http://psasir.upm.edu.my/id/eprint/103057/ |