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      Automatic identification of coronary tree anatomy in coronary computed tomography angiography

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          Abstract

          An automatic coronary artery tree labeling algorithm is described to identify the anatomical segments of the extracted centerlines from coronary computed tomography angiography (CCTA) images. This method will facilitate the automatic lesion reporting and risk stratification of cardiovascular disease. Three-dimensional (3D) models for both right dominant (RD) and left dominant (LD) coronary circulations were built. All labels in the model were matched with their possible candidates in the extracted tree to find the optimal labeling result. In total, 83 CCTA datasets with 1149 segments were included in the testing of the algorithm. The results of the automatic labeling were compared with those by two experts. In all cases, the proximal parts of main branches including LM were labeled correctly. The automatic labeling algorithm was able to identify and assign labels to 89.2% RD and 83.6% LD coronary tree segments in comparison with the agreements of the two experts (97.6% RD, 87.6% LD). The average precision of start and end points of segments was 92.0% for RD and 90.7% for LD in comparison with the manual identification by two experts while average differences in experts is 1.0% in RD and 2.2% in LD cases. All cases got similar clinical risk scores as the two experts. The presented fully automatic labeling algorithm can identify and assign labels to the extracted coronary centerlines for both RD and LD circulations.

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          Most cited references24

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          The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease.

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            Prognostic value of multidetector coronary computed tomographic angiography for prediction of all-cause mortality.

            The purpose of this study was to examine the association of all-cause death with the coronary computed tomographic angiography (CCTA)-defined extent and severity of coronary artery disease (CAD). The prognostic value of identifying CAD by CCTA remains undefined. We examined a single-center consecutive cohort of 1,127 patients > or =45 years old with chest symptoms. Stenosis by CCTA was scored as minimal ( or =70%) for each coronary artery. Plaque was assessed in 3 ways: 1) moderate or obstructive plaque; 2) CCTA score modified from Duke coronary artery score; and 3) simple clinical scores grading plaque extent and distribution. A 15.3 +/- 3.9-month follow-up of all-cause death was assessed using Cox proportional hazards models adjusted for pretest CAD likelihood and risk factors. Deaths were verified by the Social Security Death Index. The CCTA predictors of death included proximal left anterior descending artery stenosis and number of vessels with > or =50% and > or =70% stenosis (all p or =70% or 2 stenoses > or =50% (p = 0.013) to 85% survival for > or =50% LM artery stenosis (p < 0.0001). Clinical scores measuring plaque burden and distribution predicted 5% to 6% higher absolute death rate (6.6% vs. 1.6% and 8.4% vs. 2.5%; p = 0.05 for both). In patients with chest pain, CCTA identifies increased risk for all-cause death. Importantly, a negative CCTA portends an extremely low risk for death.
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              CAD-RADS(TM) Coronary Artery Disease - Reporting and Data System. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Radiology (ACR) and the North American Society for Cardiovascular Imaging (NASCI). Endorsed by the American College of Cardiology.

              The intent of CAD-RADS - Coronary Artery Disease Reporting and Data System is to create a standardized method to communicate findings of coronary CT angiography (coronary CTA) in order to facilitate decision-making regarding further patient management. The suggested CAD-RADS classification is applied on a per-patient basis and represents the highest-grade coronary artery lesion documented by coronary CTA. It ranges from CAD-RADS 0 (Zero) for the complete absence of stenosis and plaque to CAD-RADS 5 for the presence of at least one totally occluded coronary artery and should always be interpreted in conjunction with the impression found in the report. Specific recommendations are provided for further management of patients with stable or acute chest pain based on the CAD-RADS classification. The main goal of CAD-RADS is to standardize reporting of coronary CTA results and to facilitate communication of test results to referring physicians along with suggestions for subsequent patient management. In addition, CAD-RADS will provide a framework of standardization that may benefit education, research, peer-review and quality assurance with the potential to ultimately result in improved quality of care.
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                Author and article information

                Contributors
                +31 71 526 2270 , j.dijkstra@lumc.nl
                Journal
                Int J Cardiovasc Imaging
                Int J Cardiovasc Imaging
                The International Journal of Cardiovascular Imaging
                Springer Netherlands (Dordrecht )
                1569-5794
                1875-8312
                24 June 2017
                24 June 2017
                2017
                : 33
                : 11
                : 1809-1819
                Affiliations
                [1 ]ISNI 0000000089452978, GRID grid.10419.3d, Division of Image Processing, Department of Radiology, C2S, , Leiden University Medical Center, ; PO Box 9600, Albinusdreef 2, 2300 RC Leiden, The Netherlands
                [2 ]ISNI 0000000089452978, GRID grid.10419.3d, Department of Cardiology, , Leiden University Medical Center, ; Leiden, The Netherlands
                [3 ]Medis Medical Imaging Systems BV, Leiden, The Netherlands
                [4 ]ISNI 0000 0004 1761 0489, GRID grid.263826.b, Laboratory of Image Science and Technology, , Southeast University, ; Nanjing, China
                Author information
                http://orcid.org/0000-0003-1789-8155
                Article
                1169
                10.1007/s10554-017-1169-0
                5677991
                28647774
                8e26a8c7-af7c-4da2-8c4c-86f13bc5398e
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 6 December 2016
                : 17 May 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100003958, Stichting voor de Technische Wetenschappen;
                Award ID: 10084
                Award Recipient :
                Categories
                Original Paper
                Custom metadata
                © Springer Science+Business Media B.V. 2017

                Cardiovascular Medicine
                coronary computed tomography angiography (ccta),coronary artery labeling,coronary artery dominance

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