Moneera N. Haque

Mahmut S. Gokmen, Moneera N. Haque, Steve W. Leung et al.

Coronary artery calcium (CAC) scoring is a key predictor of cardiovascular risk, but it relies on ECG-gated CT scans, restricting its use to specialized cardiac imaging settings. We introduce an automated framework for CAC detection and lesion-specific Agatston scoring that operates across both gated and non-gated CT scans. At its core is CARD-ViT, a self-supervised Vision Transformer trained exclusively on gated CT data using DINO. Without any non-gated training data, our framework achieves 0.707 accuracy and a Cohen's kappa of 0.528 on the Stanford non-gated dataset, matching models trained directly on non-gated scans. On gated test sets, the framework achieves 0.910 accuracy with Cohen's kappa scores of 0.871 and 0.874 across independent datasets, demonstrating robust risk stratification. These results demonstrate the feasibility of cross-domain CAC scoring from gated to non-gated domains, supporting scalable cardiovascular screening in routine chest imaging without additional scans or annotations.

Mahmut S. Gokmen, Caner Ozcan, Moneera N. Haque et al.

Coronary artery disease (CAD), one of the leading causes of mortality worldwide, necessitates effective risk assessment strategies, with coronary artery calcium (CAC) scoring via computed tomography (CT) being a key method for prevention. Traditional methods, primarily based on UNET architectures implemented on pre-built models, face challenges like the scarcity of annotated CT scans containing CAC and imbalanced datasets, leading to reduced performance in segmentation and scoring tasks. In this study, we address these limitations by incorporating the self-supervised learning (SSL) technique of DINO (self-distillation with no labels), which trains without requiring CAC-specific annotations, enhancing its robustness in generating distinct features. The DINO-LG model, which leverages label guidance to focus on calcified areas, achieves significant improvements, with a sensitivity of 89% and specificity of 90% for detecting CAC-containing CT slices, compared to the standard DINO model's sensitivity of 79% and specificity of 77%. Additionally, false-negative and false-positive rates are reduced by 49% and 59%, respectively, instilling greater confidence in clinicians when ruling out calcification in low-risk patients and minimizing unnecessary imaging reviews by radiologists. Further, CAC scoring and segmentation tasks are conducted using a basic UNET architecture, applied specifically to CT slices identified by the DINO-LG model as containing calcified areas. This targeted approach enhances CAC scoring accuracy by feeding the UNET model with relevant slices, significantly improving diagnostic precision, reducing both false positives and false negatives, and ultimately lowering overall healthcare costs by minimizing unnecessary tests and treatments, presenting a valuable advancement in CAD risk assessment.