AGMN: Association Graph-based Graph Matching Network for Coronary Artery Semantic Labeling on Invasive Coronary Angiograms

Semantic labeling of coronary arterial segments in invasive coronary angiography (ICA) is important for automated assessment and report generation of coronary artery stenosis in the computer-aided diagnosis of coronary artery disease (CAD). Inspired by the training procedure of interventional cardiologists for interpreting the structure of coronary arteries, we propose an association graph-based graph matching network (AGMN) for coronary arterial semantic labeling. We first extract the vascular tree from invasive coronary angiography (ICA) and convert it into multiple individual graphs. Then, an association graph is constructed from two individual graphs where each vertex represents the relationship between two arterial segments. Using the association graph, the AGMN extracts the vertex features by the embedding module, aggregates the features from adjacent vertices and edges by graph convolution network, and decodes the features to generate the semantic mappings between arteries. By learning the mapping of arterial branches between two individual graphs, the unlabeled arterial segments are classified by the labeled segments to achieve semantic labeling. A dataset containing 263 ICAs was employed to train and validate the proposed model, and a five-fold cross-validation scheme was performed. Our AGMN model achieved an average accuracy of 0.8264, an average precision of 0.8276, an average recall of 0.8264, and an average F1-score of 0.8262, which significantly outperformed existing coronary artery semantic labeling methods. In conclusion, we have developed and validated a new algorithm with high accuracy, interpretability, and robustness for coronary artery semantic labeling on ICAs.

Automatic Identification of the End-Diastolic and End-Systolic Cardiac Frames from Invasive Coronary Angiography Videos

Automatic identification of proper image frames at the end-diastolic (ED) and end-systolic (ES) frames during the review of invasive coronary angiograms (ICA) is important to assess blood flow during a cardiac cycle, reconstruct the 3D arterial anatomy from bi-planar views, and generate the complementary fusion map with myocardial images. The current identification method primarily relies on visual interpretation, making it not only time-consuming but also less reproducible. In this paper, we propose a new method to automatically identify angiographic image frames associated with the ED and ES cardiac phases by using the trajectories of key vessel points (i.e. landmarks). More specifically, a detection algorithm is first used to detect the key points of coronary arteries, and then an optical flow method is employed to track the trajectories of the selected key points. The ED and ES frames are identified based on all these trajectories. Our method was tested with 62 ICA videos from two separate medical centers (22 and 9 patients in sites 1 and 2, respectively). Comparing consensus interpretations by two human expert readers, excellent agreement was achieved by the proposed algorithm: the agreement rates within a one-frame range were 92.99% and 92.73% for the automatic identification of the ED and ES image frames, respectively. In conclusion, the proposed automated method showed great potential for being an integral part of automated ICA image analysis.

A Deep Learning-based Method to Extract Lumen and Media-Adventitia in Intravascular Ultrasound Images

Intravascular ultrasound (IVUS) imaging allows direct visualization of the coronary vessel wall and is suitable for the assessment of atherosclerosis and the degree of stenosis. Accurate segmentation and measurements of lumen and median-adventitia (MA) from IVUS are essential for such a successful clinical evaluation. However, current segmentation relies on manual operations, which is time-consuming and user-dependent. In this paper, we aim to develop a deep learning-based method using an encoder-decoder deep architecture to automatically extract both lumen and MA border. Our method named IVUS-U-Net++ is an extension of the well-known U-Net++ model. More specifically, a feature pyramid network was added to the U-Net++ model, enabling the utilization of feature maps at different scales. As a result, the accuracy of the probability map and subsequent segmentation have been improved We collected 1746 IVUS images from 18 patients in this study. The whole dataset was split into a training dataset (1572 images) for the 10-fold cross-validation and a test dataset (174 images) for evaluating the performance of models. Our IVUS-U-Net++ segmentation model achieved a Jaccard measure (JM) of 0.9412, a Hausdorff distance (HD) of 0.0639 mm for the lumen border, and a JM of 0.9509, an HD of 0.0867 mm for the MA border, respectively. Moreover, the Pearson correlation and Bland-Altman analyses were performed to evaluate the correlations of 12 clinical parameters measured from our segmentation results and the ground truth, and automatic measurements agreed well with those from the ground truth (all Ps<0.01). In conclusion, our preliminary results demonstrate that the proposed IVUS-U-Net++ model has great promise for clinical use.