title: Automatic coronary calcium scoring in low-dose chest computed tomography.
abstract: The calcium burden as estimated from non-ECG-synchronized computed tomography (CT) exams acquired in screening of heavy smokers has been shown to be a strong predictor of cardiovascular events. We present a method for automatic coronary calcium scoring with low-dose, non-contrast-enhanced, non-ECG-synchronized chest CT. First, a probabilistic coronary calcium map was created using multi-atlas segmentation. This map assigned an a priori probability for the presence of coronary calcifications at every location in a scan. Subsequently, a statistical pattern recognition system was designed to identify coronary calcifications by texture, size, and spatial features; the spatial features were computed using the coronary calcium map. The detected calcifications were quantified in terms of volume and Agatston score. The best results were obtained by merging the results of three different supervised classification systems, namely direct classification with a nearest neighbor classifier, and two-stage classification with nearest neighbor and support vector machine classifiers.We used a total of 231 test scans containing 45,674 mm³ of coronary calcifications. The presented method detected on average 157/198 mm³ (sensitivity 79.2%) of coronary calcium volume with on average 4 mm false positive volume. Calcium scoring can be performed automatically in low-dose, non-contrast enhanced, non-ECG-synchronized chest CT in screening of heavy smokers to identify subjects who might benefit from preventive treatment.
authors.affiliation: Image Sciences Institute, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands. ivana@isi.uu.nl
authors.forename: Ivana
authors.initials: I
authors.lastname: Isgum
authors.forename: Mathias
authors.initials: M
authors.lastname: Prokop
authors.forename: Meindert
authors.initials: M
authors.lastname: Niemeijer
authors.forename: Max A
authors.initials: MA
authors.lastname: Viergever
authors.forename: Bram
authors.initials: B
authors.lastname: van Ginneken
mesh_terms: D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008875:Middle Aged; D010363:Pattern Recognition, Automated / Q000379:methods*; D013902:Radiography, Thoracic; D012307:Risk Factors; D012907:Smoking / Q000473:pathology; D060388:Support Vector Machine; D014057:Tomography, X-Ray Computed / Q000379:methods*