Well-balanced system for coronary calcium detection and volume measurement in a low resolution intravascular ultrasound videos.

BACKGROUND: Accurate and fast quantitative assessment of calcium volume is required during the planning of percutaneous coronary interventions procedures. Low resolution in intravascular ultrasound (IVUS) coronary videos poses a threat to calcium detection causing over-estimation in volume measurement. We introduce a correction block that counter-balances the bias introduced during the calcium detection process.

METHOD: Nineteen patients image dataset (around 40,090 frames), IRB approved, were collected using 40MHz IVUS catheter (Atlantis® SR Pro, Boston Scientific®, pullback speed of 0.5mm/sec). A new set of 20 generalized and well-balanced systems each consisting of three stages: (i) calcium detection, (ii) calibration and (iii) measurement, while ensuring accuracy of four soft classifiers (Threshold, FCM, K-means and HMRF) and workflow speed using five multiresolution techniques (bilinear, bicubic, wavelet, Lanczos, Gaussian Pyramid) were designed. Results of the three calcium detection methods were benchmarked against the Threshold-based method.

RESULTS: All 20 well-balanced systems with calibration block show superior performance. Using calibration block, FCM versus Threshold-based method shows the highest cross-correlation 0.99 (P<0.0001), Jaccard index 0.984±0.013 (P<0.0001), and Dice similarity 0.992±0.007 (P<0.0001). The corresponding area under the curve for four calcium detection techniques is: 1.0, 1.0, 0.97 and 0.93, respectively. The mean overall performance improvement is 38.54% and when adapting calibration block. The mean workflow speed improvement is 62.14% when adapting multiresolution paradigm. Three clinical tests shows consistency, reliability, and stability of our well-balanced system.

CONCLUSIONS: A well-balanced system with a combination of Threshold embedded with Lanczos multiresolution was optimal and can be useable in clinical settings.