ODySSeI: An Open-Source End-to-End Framework for Automated Detection, Segmentation, and Severity Estimation of Lesions in Invasive Coronary Angiography Images
This provides an automated, reproducible tool for real-time clinical decision-making in cardiology, though it is incremental as it builds on existing deep learning methods with specific enhancements.
The paper tackles the problem of subjective and variable interpretation of Invasive Coronary Angiography (ICA) images for coronary artery disease by introducing ODySSeI, an open-source framework that automates lesion detection, segmentation, and severity estimation, achieving a 2.5-fold increase in lesion detection performance and high accuracy in severity estimation with MLD differences of ±2-3 pixels.
Invasive Coronary Angiography (ICA) is the clinical gold standard for the assessment of coronary artery disease. However, its interpretation remains subjective and prone to intra- and inter-operator variability. In this work, we introduce ODySSeI: an Open-source end-to-end framework for automated Detection, Segmentation, and Severity estimation of lesions in ICA images. ODySSeI integrates deep learning-based lesion detection and lesion segmentation models trained using a novel Pyramidal Augmentation Scheme (PAS) to enhance robustness and real-time performance across diverse patient cohorts (2149 patients from Europe, North America, and Asia). Furthermore, we propose a quantitative coronary angiography-free Lesion Severity Estimation (LSE) technique that directly computes the Minimum Lumen Diameter (MLD) and diameter stenosis from the predicted lesion geometry. Extensive evaluation on both in-distribution and out-of-distribution clinical datasets demonstrates ODySSeI's strong generalizability. Our PAS yields large performance gains in highly complex tasks as compared to relatively simpler ones, notably, a 2.5-fold increase in lesion detection performance versus a 1-3\% increase in lesion segmentation performance over their respective baselines. Our LSE technique achieves high accuracy, with predicted MLD values differing by only $\pm$ 2-3 pixels from the corresponding ground truths. On average, ODySSeI processes a raw ICA image within only a few seconds on a CPU and in a fraction of a second on a GPU and is available as a plug-and-play web interface at swisscardia.epfl.ch. Overall, this work establishes ODySSeI as a comprehensive and open-source framework which supports automated, reproducible, and scalable ICA analysis for real-time clinical decision-making.