A novel deep learning model for a computed tomography diagnosis of coronary plaque erosion.

Journal: Scientific reports
PMID: 38151502

Abstract

Patients with acute coronary syndromes caused by plaque erosion might be managed conservatively without stenting. Currently, the diagnosis of plaque erosion requires an invasive imaging procedure. We sought to develop a deep learning (DL) model that enables an accurate diagnosis of plaque erosion using coronary computed tomography angiography (CTA). A total of 532 CTA scans from 395 patients were used to develop a DL model: 426 CTA scans from 316 patients for training and internal validation, and 106 separate scans from 79 patients for validation. Momentum Distillation-enhanced Composite Transformer Attention (MD-CTA), a novel DL model that can effectively process the entire set of CTA scans to diagnose plaque erosion, was developed. The novel DL model, compared to the convolution neural network, showed significantly improved AUC (0.899 [0.841-0.957] vs. 0.724 [0.622-0.826]), sensitivity (87.1 [70.2-96.4] vs. 71.0 [52.0-85.8]), and specificity (85.3 [75.3-92.4] vs. 68.0 [56.2-78.3]), respectively, for the patient-level prediction. Similar results were obtained at the slice-level prediction AUC (0.897 [0.890-0.904] vs. 0.757 [0.744-0.770]), sensitivity (82.2 [79.8-84.3] vs. 68.9 [66.2-71.6]), and specificity (80.1 [79.1-81.0] vs. 67.3 [66.3-68.4]), respectively. This newly developed DL model enables an accurate CT diagnosis of plaque erosion, which might enable cardiologists to provide tailored therapy without invasive procedures.Clinical Trial Registration: http://www.clinicaltrials.gov , NCT04523194.

Authors

  • Sangjoon Park
  • Haruhito Yuki
    Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA.
  • Takayuki Niida
    Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA.
  • Keishi Suzuki
    Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA.
  • Daisuke Kinoshita
    Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA.
  • Iris McNulty
    Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, MA, 02114, USA.
  • Alexander Broersen
    Department of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands.
  • Jouke Dijkstra
    Department of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands.
  • Hang Lee
    Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Tsunekazu Kakuta
    Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan. kaz@joy.email.ne.jp.
  • Jong Chul Ye
  • Ik-Kyung Jang
    Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, USA.

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