Performance of a deep learning algorithm for the evaluation of CAD-RADS classification with CCTA. Journal Article

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Authors: Muscogiuri, G; Chiesa, M; Trotta, M; Gatti, M; Palmisano, V; Dell'Aversana, S; Baessato, F; Cavaliere, A; Cicala, G; Loffreno, A; Rizzon, G; Guglielmo, M; Baggiano, A; Fusini, L; Saba, L; Andreini, D; Pepi, M; Rabbat, MG; Guaricci, AI; De Cecco, CN; Colombo, G; Pontone, G
Article Title: Performance of a deep learning algorithm for the evaluation of CAD-RADS classification with CCTA.
Abstract: BACKGROUND AND AIMS: Artificial intelligence (AI) is increasing its role in diagnosis of patients with suspicious coronary artery disease. The aim of this manuscript is to develop a deep convolutional neural network (CNN) to classify coronary computed tomography angiography (CCTA) in the correct Coronary Artery Disease Reporting and Data System (CAD-RADS) category. METHODS: Two hundred eighty eight patients who underwent clinically indicated CCTA were included in this single-center retrospective study. The CCTAs were stratified by CAD-RADS scores by expert readers and considered as reference standard. A deep CNN was designed and tested on the CCTA dataset and compared to on-site reading. The deep CNN analyzed the diagnostic accuracy of the following three Models based on CAD-RADS classification: Model A (CAD-RADS 0 vs CAD-RADS 1-2 vs CAD-RADS 3,4,5), Model 1 (CAD-RADS 0 vs CAD-RADS>0), Model 2 (CAD-RADS 0-2 vs CAD-RADS 3-5). Time of analysis for both physicians and CNN were recorded. RESULTS: Model A showed a sensitivity, specificity, negative predictive value, positive predictive value and accuracy of 47%, 74%, 77%, 46% and 60%, respectively. Model 1 showed a sensitivity, specificity, negative predictive value, positive predictive value and accuracy of 66%, 91%, 92%, 63%, 86%, respectively. Conversely, Model 2 demonstrated the following sensitivity, specificity, negative predictive value, positive predictive value and accuracy: 82%, 58%, 74%, 69%, 71%, respectively. Time of analysis was significantly lower using CNN as compared to on-site reading (530.5 ± 179.1 vs 104.3 ± 1.4 sec, p=0.01) CONCLUSIONS: Deep CNN yielded accurate automated classification of patients with CAD-RADS.
Journal Title: Atherosclerosis
ISSN: 1879-1484; 0021-9150
Publisher: Elsevier Inc  
Date Published: 2019