Choi Joo Hyeok, Cha Min Jae, Cho Iksung, Kim William D, Ha Yera, Choi Hyewon, Lee Sun Hwa, You Seng Chan, Chang Jee Suk
Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea.
Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Front Oncol. 2022 Sep 20;12:989250. doi: 10.3389/fonc.2022.989250. eCollection 2022.
This study aimed to demonstrate clinical feasibility of deep learning (DL)-based fully automated coronary artery calcium (CAC) scoring software using non-electrocardiogram (ECG)-gated chest computed tomography (CT) from patients with cancer. Overall, 913 patients with colorectal or gastric cancer who underwent non-contrast-enhanced chest CT between 2013 and 2015 were included. Agatston scores obtained by manual segmentation of CAC on chest CT were used as reference. Reliability of automated CAC score acquisition was evaluated using intraclass correlation coefficients (ICCs). The agreement for cardiovascular disease (CVD) risk stratification was assessed with linearly weighted k statistics. ICCs between the manual and automated CAC scores were 0.992 (95% CI, 0.991 and 0.993, <0.001) for total Agatston scores, 0.863 (95% CI, 0.844 and 0.880, <0.001) for the left main, 0.964 (95% CI, 0.959 and 0.968, <0.001) for the left anterior descending, 0.962 (95% CI, 0.956 and 0.966, <0.001) for the left circumflex, and 0.980 (95% CI, 0.978 and 0.983, <0.001) for the right coronary arteries. The agreement for cardiovascular risk was excellent (k=0.946, <0.001). Current DL-based automated CAC software showed excellent reliability for Agatston score and CVD risk stratification using non-ECG gated CT scans and might allow the identification of high-risk cancer patients for CVD.
本研究旨在证明基于深度学习(DL)的全自动冠状动脉钙化(CAC)评分软件在使用癌症患者的非心电图(ECG)门控胸部计算机断层扫描(CT)时的临床可行性。总体而言,纳入了2013年至2015年间接受非增强胸部CT的913例结直肠癌或胃癌患者。通过手动分割胸部CT上的CAC获得的阿加斯顿评分用作参考。使用组内相关系数(ICC)评估自动获取CAC评分的可靠性。用线性加权k统计量评估心血管疾病(CVD)风险分层的一致性。总阿加斯顿评分的手动和自动CAC评分之间的ICC为0.992(95%CI,0.991和0.993,<0.001),左主干为0.863(95%CI,0.844和0.880,<0.001),左前降支为0.964(95%CI,0.959和0.968,<0.001),左旋支为0.962(95%CI,0.956和0.966,<0.001),右冠状动脉为0.980(95%CI,0.978和0.983,<0.001)。心血管风险的一致性极佳(k=0.946,<0.001)。当前基于DL的自动CAC软件在使用非ECG门控CT扫描时,对阿加斯顿评分和CVD风险分层显示出极佳的可靠性,并且可能有助于识别CVD高危癌症患者。