Background: Accurate extraction of coronary arteries from invasive coronary angiography (ICA) images is essential for the diagnosis and risk stratification of coronary artery disease (CAD).
Objective: In this study, a novel deep learning (DL) method is proposed for automatically extracting coronary arteries from ICA images.
Methods: A convolutional neural network (CNN) was developed with full-scale skip connections and full-scale deep supervisions. The encoder architecture was based on the residual and inception modules to obtain multi-scale features from multiple convolutional layers with different window shapes. Transfer learning was utilized to improve both the initial performance and learning efficiency. A hybrid loss function was employed to further optimize the segmentation model.
Results: The model was tested on a data set of 616 ICAs obtained from 210 patients, composed of 437 images for training, 49 images for validation, and 130 images for testing. The segmentation model achieved a Dice score of 0.8942, a sensitivity of 0.8735, a specificity of 0.9954, and a Hausdorff distance of 6.0794 mm; it could predict arteries for a single ICA frame in 0.2114 seconds.
Conclusions: The results showed that our model outperformed the state-of-the-art deep-learning models. Our new method has great potential for clinical use.
Keywords: Coronary artery disease; convolutional neural network; deep learning; image segmentation; invasive coronary angiography.