Deep learning based automatic quantification of aortic valve calcification on contrast enhanced coronary CT angiography.
Journal:
Scientific reports
PMID:
40069321
Abstract
Quantifying aortic valve calcification is critical for assessing the severity of aortic stenosis, predicting cardiovascular risk, and guiding treatment decisions. This study evaluated the feasibility of a deep learning-based automatic quantification of aortic valve calcification using contrast-enhanced coronary CT angiography and compared the results with manual calcium scoring. A retrospective analysis of 177 patients undergoing aortic stenosis evaluation was conducted, divided into a development set (n = 97) and an internal validation set (n = 80). The DeepLab v3 + model segmented the ascending aorta, and the XGBoost model refined the aortic valve region using representative attenuation values. Calcifications were identified with a tailored threshold based on these values and quantified using a weighted scoring method analogous to the Agatston score. The automated method showed excellent agreement with manual Agatston scores derived from non-contrast CT (Pearson correlation coefficient = 0.93, 95% confidence interval [CI]: 0.89-0.95, p < 0.001, concordance correlation coefficient = 0.92, 95% CI: 0.87-0.95). For classifying severe aortic stenosis, defined by calcium scores exceeding 2000 for men and 1300 for women, the approach achieved a sensitivity of 88.6%, specificity of 91.1%, and overall accuracy of 90.0%. This deep learning model provides automated aortic valve calcification quantification with high accuracy on enhanced CT. This approach offers an alternative for measuring aortic valve calcium when non-contrast CT is unavailable, with the potential to reduce reliance on non-contrast CT, minimize operator dependency, and lower patient radiation exposure.