Eranthi Jayawardena

Automated estimation of image quality for coronary computed tomographic angiography using machine learning

ObjectivesOur goal was to evaluate the efficacy of a fully automated method for assessing the image quality (IQ) of coronary computed tomography angiography (CCTA).MethodsThe machine learning method was trained using 75 CCTA studies by mapping features (noise, contrast, misregistration scores, and un-interpretability index) to an IQ score based on manual ground truth data. The automated method was validated on a set of 50 CCTA studies and subsequently tested on a new set of 172 CCTA studies against visual IQ scores on a 5-point Likert scale.ResultsThe area under the curve in the validation set was 0.96. In the 172 CCTA studies, our method yielded a Cohen’s kappa statistic for the agreement between automated and visual IQ assessment of 0.67 (p < 0.01). In the group where good to excellent (n = 163), fair (n = 6), and poor visual IQ scores (n = 3) were graded, 155, 5, and 2 of the patients received an automated IQ score > 50 %, respectively.ConclusionFully automated assessment of the IQ of CCTA data sets by machine learning was reproducible and provided similar results compared with visual analysis within the limits of inter-operator variability.Key points• The proposed method enables automated and reproducible image quality assessment.• Machine learning and visual assessments yielded comparable estimates of image quality.• Automated assessment potentially allows for more standardised image quality.• Image quality assessment enables standardization of clinical trial results across different datasets.

Correlation of Arterial Stiffness With Left Atrial Volume Index and Left Ventricular Mass Index in Young Adults: Evaluation by Coronary Computed Tomography Angiography

BACKGROUND Increased arterial stiffness is reportedly associated with cardiac remodelling, including the left atrium and left ventricle, in middle-aged and older adults. However, little is known about this association in young adults. METHODS In total, 73 patients (44 (60%) men) aged 25 to 45 years with suspected coronary artery disease were included in the analysis. The left atrial volume index (LAVI), left ventricular volume index (LVVI), and left ventricular mass index (LVMI) were measured using coronary computed tomography angiography (CCTA). Arterial stiffness was assessed with the cardio-ankle vascular index (CAVI). An abnormally high CAVI was defined as that above the age- and sex-specific cut-off points of the CAVI. RESULTS Compared with patients with a normal CAVI, those with an abnormally high CAVI were older and had a greater prevalence of diabetes mellitus, higher diastolic blood pressure, greater coronary artery calcification score, and a greater LAVI (33.5±10.3 vs. 43.0±10.3mL/m2, p <0.01). In contrast, there were no significant differences in the LVVI or LVMI between the subgroups with a normal CAVI and an abnormally high CAVI. Multivariate linear regression analysis showed that the LAVI was significantly associated with an abnormally high CAVI (standardised regression coefficient=0.283, p=0.03). CONCLUSIONS The present study demonstrated that increased arterial stiffness is associated with the LAVI, which reflects the early stages of cardiac remodelling, independent of various comorbidity factors in young adults with suspected coronary artery disease.

IMPACT OF CARDIAC TROPONIN I ON THE PRESENCE OF THE CORONARY ARTERY PLAQUE IN RHEUMATOID ARTHRITIS PATIENTS

Introduction: The presence of accelerated coronary artery disease in rheumatoid arthritis (RA) was previously reported. The goal of this study was to investigate if using high sensitivity cardiac troponin I (hs-cTnI) identifies patients at higher coronary atherosclerosis risk. Method: A total of

THE UTILITY OF LEFT ATRIAL APPENDAGE HOUNSFIELD UNIT AND THE RATIO OF LEFT ATRIAL APPENDAGE/ASCENDING AORTA HOUNSFIELD UNIT FOR DETECTING LEFT ATRIAL APPENDAGE THROMBUS

Background: Atrial fibrillation (AF) increases the risk of thromboembolic events by promoting thrombus formation in the left atrial appendage (LAA). Delayed enhancement by cardiac computed tomography angiography (CCTA) is a reliable method in evaluating LAA thrombus. Previously, studies using CCTA

Multicenter Aids Cohort Study Quantitative Coronary Plaque Progression Study: rationale and design

Background and aim The association of HIV with coronary atherosclerosis has been established; however, the progression of coronary atherosclerosis over time among participants with HIV is not well known. The Multicenter AIDS Cohort Study Quantitative Coronary Plaque Progression Study is a large prospective multicenter study quantifying progression of coronary plaque assessed by serial coronary computed tomography angiography (CTA). Patients and methods HIV-infected and uninfected men who were enrolled in the Multicenter AIDS Cohort Study Cardiovascular Substudy were eligible to complete a follow-up contrast coronary CTA 3–6 years after baseline. We measured coronary plaque volume and characteristics (calcified and noncalcified plaque including fibrous, fibrous-fatty, and low attenuation) and vulnerable plaque among HIV-infected and uninfected men using semiautomated plaque software to investigate the progression of coronary atherosclerosis over time. Conclusion We describe a novel, large prospective multicenter study investigating incidence, transition of characteristics, and progression in coronary atherosclerosis quantitatively assessed by serial coronary CTAs among HIV-infected and uninfected men.