Deep Learning for Quantification of Epicardial and Thoracic Adipose Tissue From Non-Contrast CT

Abstract

Epicardial adipose tissue (EAT) is a visceral fat deposit related to coronary artery disease. Fully automated quantification of EAT volume in clinical routine could be a timesaving and reliable tool for cardiovascular risk assessment. We propose a new fully automated deep learning framework for EAT and thoracic adipose tissue (TAT) quantification from non-contrast coronary artery calcium computed tomography (CT) scans. The first multi-task convolutional neural network (ConvNet) is used to determine heart limits and perform segmentation of heart and adipose tissues. The second ConvNet, combined with a statistical shape model, allows for pericardium detection. EAT and TAT segmentations are then obtained from outputs of both ConvNets. We evaluate the performance of the method on CT data sets from 250 asymptomatic individuals. Strong agreement between automatic and expert manual quantification is obtained for both EAT and TAT with median Dice score coefficients of 0.823 (inter-quartile range (IQR): 0.779-0.860) and 0.905 (IQR: 0.862-0.928), respectively; with excellent correlations of 0.924 and 0.945 for EAT and TAT volumes. Computations are performed in <6 s on a standard personal computer for one CT scan. Therefore, the proposed method represents a tool for rapid fully automated quantification of adipose tissue and may improve cardiovascular risk stratification in patients referred for routine CT calcium scans.

Evaluation of automated computed tomography segmentation to assess body composition and mortality associations in cancer patients

“…Various automatic methods have been developed for tissue segmentation from CT scans. [5][6][7][8][9][10][11][12][13][14] Many methods focused either on the segmentation of muscle [6][7][8]10 or adipose tissue 5,11,14,21 but not both. Most methods for muscle tissue segmentation only considered single muscles such as diaphragm, psoas major, and rectus abdominis, [6][7][8] as opposed to total L3 skeletal muscle tissue area.…”

Deep Learning in Cardiology

“…Method Application/Notes a CT Lessman 2016 [195] CNN detect coronary calcium using three independently trained CNNs Shadmi 2018 [196] DenseNet compared DenseNet and u-net for detecting coronary calcium Cano 2018 [197] CNN 3D regression CNN for calculation of the Agatston score Wolterink 2016 [198] CNN detect coronary calcium using three CNNs for localization and two CNNs for detection Santini 2017 [199] CNN coronary calcium detection using a seven layer CNN on image patches Lopez 2017 [200] CNN thrombus volume characterization using a 2D CNN and postprocessing Hong 2016 [201] DBN detection, segmentation, classification of abdominal aortic aneurysm using DBN and image patches Liu 2017 [202] CNN left atrium segmentation using a twelve layer CNN and active shape model (STA13) de Vos 2016 [203] CNN 3D localization of anatomical structures using three CNNs, one for each orthogonal plane Moradi 2016 [204] CNN detection of position for a given CT slice using a pretrained VGGnet, handcrafted features and SVM Zheng 2015 [205] Multiple carotid artery bifurcation detection using multi-layer perceptrons and probabilistic boosting-tree Montoya 2018 [206] ResNet 3D reconstruction of cerebral angiogram using a 30 layer ResNet Zreik 2018 [207] CNN, AE identify coronary artery stenosis using CNN for LV segmentation and an AE, SVM for classification Commandeur 2018 [208] CNN quantification of epicardial and thoracic adipose tissue from non-contrast CT Gulsun 2016 [209] CNN extract coronary centerline using optimal path from computed flow field and a CNN for refinement CNN carotid intima media thickness video interpretation using two CNNs with two layers on Ultrasound Tom 2017 [226] GAN IVUS image generation using two GANs (IV11) Wang 2017 [227] CNN breast arterial calcification using a ten layer CNN on mammograms Liu 2017 [228] CNN CAC detection using CNNs on 1768 X-Rays Pavoni 2017 [229] CNN denoising of percutaneous transluminal coronary angioplasty images using four layer CNN Nirschl 2018 [230] CNN trained a patch-based six layer CNN for identifying heart failure in endomyocardial biopsy images Betancur 2018 [231] CNN trained a three layer CNN for obstructive CAD prediction from myocardial perfusion imaging a Results from these imaging modalities are not reported in this review because they were highly variable in terms of the research question they were trying to solve and highly inconsistent in respect with the use of metrics. Additionally all papers use private databases besides…”

“…Similar work has been done by the same authors in [233] which they use three CNNs to detect a bounding box around the LV and perform LV voxel classification within the bounding box. Commandeur et al [208] used a combination of two deep networks to quantify epicardial and thoracic apidose tissue in CT from 250 patients with 55 slices per patient on average. The first network is a six layer CNN that detects the slice located within heart limits, and segments the thoracic and epicardial-paracardial masks.…”

Latest Advances in Cardiac CT

“…In addition, it will be able to automatically quantify markers, such as calcium scoring, epicardial fat volumes and liver Hounsfield units (to diagnose fatty liver), and plug these data into scoring systems. 61 ML and its applications to CTCA has been previously very well reviewed. 62 The integration of ML into clinical practice will bring exciting and adding it to stenosis severity.…”