Joost Daemen

Mohammad Haft-Javaherian, Martin Villiger, Kenichiro Otsuka et al.

Intravascular ultrasound and optical coherence tomography are widely available for characterizing coronary stenoses and provide critical vessel parameters to optimize percutaneous intervention. Intravascular polarization-sensitive optical coherence tomography (PS-OCT) simultaneously provides high-resolution cross-sectional images of vascular structures while also revealing preponderant tissue components such as collagen and smooth muscle and thereby enhances plaque characterization. Automated interpretation of these features promises to facilitate the objective clinical investigation of the natural history and significance of coronary atheromas. Here, we propose a convolutional neural network model, optimized using a new multi-term loss function, to classify the lumen, intima, and media layers in addition to the guidewire and plaque shadows. We demonstrate that our multi-class classification model outperforms state-of-the-art methods in detecting the coronary anatomical layers. Furthermore, the proposed model segments two classes of common imaging artifacts and detects the anatomical layers within the thickened vessel wall regions that were excluded from analysis by other studies. The source code and the trained model are publicly available at https://github.com/mhaft/OCTseg

Julian Suk, Jolanda J. Wentzel, Patryk Rygiel et al.

Leveraging big data for patient care is promising in many medical fields such as cardiovascular health. For example, hemodynamic biomarkers like wall shear stress could be assessed from patient-specific medical images via machine learning algorithms, bypassing the need for time-intensive computational fluid simulation. However, it is extremely challenging to amass large-enough datasets to effectively train such models. We could address this data scarcity by means of self-supervised pre-training and foundations models given large datasets of geometric artery models. In the context of coronary arteries, leveraging learned representations to improve hemodynamic biomarker assessment has not yet been well studied. In this work, we address this gap by investigating whether a large dataset (8449 shapes) consisting of geometric models of 3D blood vessels can benefit wall shear stress assessment in coronary artery models from a small-scale clinical trial (49 patients). We create a self-supervised target for the 3D blood vessels by computing the heat kernel signature, a quantity obtained via Laplacian eigenvectors, which captures the very essence of the shapes. We show how geometric representations learned from this datasets can boost segmentation of coronary arteries into regions of low, mid and high (time-averaged) wall shear stress even when trained on limited data.

Hua Ma, Ihor Smal, Joost Daemen et al.

Percutaneous coronary intervention (PCI) is typically performed with image guidance using X-ray angiograms in which coronary arteries are opacified with X-ray opaque contrast agents. Interventional cardiologists typically navigate instruments using non-contrast-enhanced fluoroscopic images, since higher use of contrast agents increases the risk of kidney failure. When using fluoroscopic images, the interventional cardiologist needs to rely on a mental anatomical reconstruction. This paper reports on the development of a novel dynamic coronary roadmapping approach for improving visual feedback and reducing contrast use during PCI. The approach compensates cardiac and respiratory induced vessel motion by ECG alignment and catheter tip tracking in X-ray fluoroscopy, respectively. In particular, for accurate and robust tracking of the catheter tip, we proposed a new deep learning based Bayesian filtering method that integrates the detection outcome of a convolutional neural network and the motion estimation between frames using a particle filtering framework. The proposed roadmapping and tracking approaches were validated on clinical X-ray images, achieving accurate performance on both catheter tip tracking and dynamic coronary roadmapping experiments. In addition, our approach runs in real-time on a computer with a single GPU and has the potential to be integrated into the clinical workflow of PCI procedures, providing cardiologists with visual guidance during interventions without the need of extra use of contrast agent.