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  1. Article ; Online: Simultaneous assessment of heart and lungs with gated high-pitch ultra-low dose chest CT using artificial intelligence-based calcium scoring

    Florian Andre / Sebastian Seitz / Philipp Fortner / Thomas Allmendinger / André Sommer / Matthias Brado / Roman Sokiranski / Joana Fink / Hans-Ulrich Kauczor / Claus P. Heussel / Felix Herth / Norbert Frey / Johannes Görich / Sebastian J. Buss

    European Journal of Radiology Open, Vol 10, Iss , Pp 100481- (2023)

    2023  

    Abstract: Purpose: The combined testing for coronary artery and pulmonary diseases is of clinical interest as risk factors are shared. In this study, a novel ECG-gated tin-filtered ultra-low dose chest CT protocol (GCCT) for integrated heart and lung acquisition ... ...

    Abstract Purpose: The combined testing for coronary artery and pulmonary diseases is of clinical interest as risk factors are shared. In this study, a novel ECG-gated tin-filtered ultra-low dose chest CT protocol (GCCT) for integrated heart and lung acquisition and the applicability of artificial intelligence (AI)-based coronary artery calcium scoring were assessed. Methods: In a clinical registry of 10481 patients undergoing heart and lung CT, GCCT was applied in 44 patients on a dual-source CT. Coronary calcium scans (CCS) with 120 kVp, 100 kVp, and tin-filtered 100 kVp (Sn100) of controls, matched with regard to age, sex, and body-mass index, were retrieved from the registry (ntotal=176, 66.5 (59.4–74.0) years, 52 men). Automatic tube current modulation was used in all scans. In 20 patients undergoing GCCT and Sn100 CCS, Agatston scores were measured both semi-automatically by experts and by AI, and classified into six groups (0, <10, <100, <400, <1000, ≥1000). Results: Effective dose decreased significantly from 120 kVp CCS (0.50 (0.41–0.61) mSv) to 100 kVp CCS (0.34 (0.26–0.37) mSv) to Sn100 CCS (0.14 (0.11–0.17) mSv). GCCT showed higher values (0.28 (0.21–0.32) mSv) than Sn100 CCS but lower than 120 kVp and 100 kVp CCS (all p < 0.05) despite greater scan length. Agatston scores correlated strongly between GCCT and Sn100 CCS in semi-automatic and AI-based measurements (both ρ = 0.98, p < 0.001) resulting in high agreement in Agatston score classification (κ = 0.97, 95% CI 0.92–1.00; κ = 0.89, 95% CI 0.79–0.99). Regarding chest findings, further diagnostic steps were recommended in 28 patients. Conclusions: GCCT allows for reliable coronary artery disease and lung cancer screening with ultra-low radiation exposure. GCCT-derived Agatston score shows excellent agreement with standard CCS, resulting in equivalent risk stratification.
    Keywords Coronary artery disease ; Coronary artery calcium scoring ; Chest CT ; Tin-filter ; Dose reduction ; Artificial intelligence ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
    Subject code 610
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Human AI Teaming for Coronary CT Angiography Assessment

    Florian Andre / Philipp Fortner / Matthias Aurich / Sebastian Seitz / Ann-Kathrin Jatsch / Max Schöbinger / Michael Wels / Martin Kraus / Mehmet Akif Gülsün / Norbert Frey / Andre Sommer / Johannes Görich / Sebastian J. Buss

    Diagnostics, Vol 13, Iss 23, p

    Impact on Imaging Workflow and Diagnostic Accuracy

    2023  Volume 3574

    Abstract: As the number of coronary computed tomography angiography (CTA) examinations is expected to increase, technologies to optimize the imaging workflow are of great interest. The aim of this study was to investigate the potential of artificial intelligence ( ... ...

    Abstract As the number of coronary computed tomography angiography (CTA) examinations is expected to increase, technologies to optimize the imaging workflow are of great interest. The aim of this study was to investigate the potential of artificial intelligence (AI) to improve clinical workflow and diagnostic accuracy in high-volume cardiac imaging centers. A total of 120 patients (79 men; 62.4 (55.0–72.7) years; 26.7 (24.9–30.3) kg/m 2 ) undergoing coronary CTA were randomly assigned to a standard or an AI-based (human AI) coronary analysis group. Severity of coronary artery disease was graded according to CAD-RADS. Initial reports were reviewed and changes were classified. Both groups were similar with regard to age, sex, body mass index, heart rate, Agatston score, and CAD-RADS. The time for coronary CTA assessment (142.5 (106.5–215.0) s vs. 195.0 (146.0–265.5) s; p < 0.002) and the total reporting time (274.0 (208.0–377.0) s vs. 350 (264.0–445.5) s; p < 0.02) were lower in the human AI than in the standard group. The number of cases with no, minor, or CAD-RADS relevant changes did not differ significantly between groups (52, 7, 1 vs. 50, 8, 2; p = 0.80). AI-based analysis significantly improves clinical workflow, even in a specialized high-volume setting, by reducing CTA analysis and overall reporting time without compromising diagnostic accuracy.
    Keywords coronary artery disease ; coronary CT angiography ; artificial intelligence ; workflow ; human AI teaming ; computed tomography ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2023-11-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Normalizing Flows for Out-of-Distribution Detection

    Costin Florian Ciușdel / Lucian Mihai Itu / Serkan Cimen / Michael Wels / Chris Schwemmer / Philipp Fortner / Sebastian Seitz / Florian Andre / Sebastian Johannes Buß / Puneet Sharma / Saikiran Rapaka

    Applied Sciences, Vol 12, Iss 3839, p

    Application to Coronary Artery Segmentation

    2022  Volume 3839

    Abstract: Coronary computed tomography angiography (CCTA) is an effective imaging modality, increasingly accepted as a first-line test to diagnose coronary artery disease (CAD). The accurate segmentation of the coronary artery lumen on CCTA is important for the ... ...

    Abstract Coronary computed tomography angiography (CCTA) is an effective imaging modality, increasingly accepted as a first-line test to diagnose coronary artery disease (CAD). The accurate segmentation of the coronary artery lumen on CCTA is important for the anatomical, morphological, and non-invasive functional assessment of stenoses. Hence, semi-automated approaches are currently still being employed. The processing time for a semi-automated lumen segmentation can be reduced by pre-selecting vessel locations likely to require manual inspection and by submitting only those for review to the radiologist. Detection of faulty lumen segmentation masks can be formulated as an Out-of-Distribution (OoD) detection problem. Two Normalizing Flows architectures are investigated and benchmarked herein: a Glow-like baseline, and a proposed one employing a novel coupling layer. Synthetic mask perturbations are used for evaluating and fine-tuning the learnt probability densities. Expert annotations on a separate test-set are employed to measure detection performance relative to inter-user variability. Regular coupling-layers tend to focus more on local pixel correlations and to disregard semantic content. Experiments and analyses show that, in contrast, the proposed architecture is capable of capturing semantic content and is therefore better suited for OoD detection of faulty lumen segmentations. When compared against expert consensus, the proposed model achieves an accuracy of 78.6% and a sensitivity of 76%, close to the inter-user mean of 80.9% and 79%, respectively, while the baseline model achieves an accuracy of 64.3% and a sensitivity of 48%.
    Keywords out-of-distribution ; normalizing flows ; coronary computed tomography angiography ; lumen segmentation ; Technology ; T ; Engineering (General). Civil engineering (General) ; TA1-2040 ; Biology (General) ; QH301-705.5 ; Physics ; QC1-999 ; Chemistry ; QD1-999
    Subject code 004
    Language English
    Publishing date 2022-04-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Factors influencing the safety of outpatient coronary CT angiography

    Norbert Frey / Florian André / Sebastian J Buss / Philipp Fortner / Mostafa Emami / Sebastian Seitz / Matthias Brado / Friedemann Gückel / Roman Sokiranski / André Sommer / Johannes Görich

    BMJ Open, Vol 12, Iss

    a clinical registry study

    2022  Volume 8

    Abstract: Objectives Since the safety of coronary CT angiography (CTA) is of great importance, especially with regard to widening indications and increasing morbidity, the aim of this study was to assess influencing factors.Methods Patients undergoing coronary CTA ...

    Abstract Objectives Since the safety of coronary CT angiography (CTA) is of great importance, especially with regard to widening indications and increasing morbidity, the aim of this study was to assess influencing factors.Methods Patients undergoing coronary CTA in a third-generation dual-source CT in a radiological centre were included in a clinical registry. Up to 20 mg metoprolol was administered intravenously to attain a heart rate ≤65/min. Glyceryl trinitrate (GTN) was administered in doses of 0.8 mg and 0.4 mg. Blood pressure was measured before the administration and after the CTA.Results Out of 5500 consecutive patients (3194 men, 62.3 (54.9–70.0) years), adverse events occurred in 68 patients (1.2%) with mild anaphylactoid reactions (0.4%), vasovagal symptoms (0.3%) and extravasation (0.3%) being most frequent. Anti-allergic drugs were given in 17 patients, atropine in 3 patients and volume in 1 patient. Drug administration resulted in a significant mean arterial pressure decline (96.0 (88.3–106.0) vs 108.7 (99.7–117.3) mmHg; p<0.001). Patients who suffered systolic blood pressure drops >20 mmHg or >40 mmHg were older (66.5 (58.6–73.3) vs 60.5 (53.6–68.3) years; 70.2 (63.3–76.5) vs 62.1 (54.7–69.6) years), more often male (65.1% vs 54.4%; 68.9% vs 57.3%) and had higher Agatston score equivalents (83.0 (2.0–432.0) vs 15.0 (0.0–172.0); 163.0 (16.3–830.8) vs 25.0 (0.0–220.0); all p<0.001). GTN dose reduction lowered the fraction of patients suffering from blood pressure drops >20 mmHg or >40 mmHg from 34.5% to 27.4% and from 6.1% to 3.5% (both p<0.001), respectively. The proportion of coronary segments with impaired image quality did not differ significantly.Conclusions Coronary CTA with intravenous beta-blocker administration is a safe procedure in an outpatient setting as adverse events are rare and mostly mild. Reduced GTN doses can further improve safety by lowering the rate of significant blood pressure drops, which occurred especially in elderly men with increased plaque burden.Trial ...
    Keywords Medicine ; R
    Subject code 610
    Language English
    Publishing date 2022-08-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

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