Coronary Artery Stenosis Estimation Using Machine Learning

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Solution Overview

Problem

Current methods for determining the extent of anatomical narrowing in coronary artery disease, such as quantitative coronary angiography and quantitative computed tomography, are invasive or time-consuming and struggle to accurately estimate healthy lumen diameters in diffuse, ostial, and bifurcation lesions where clear distinctions between healthy and diseased lumen diameters are absent.

Innovation Solution

The system and method use a database of healthy vessel sections from individuals to estimate healthy lumen diameters through machine learning algorithms, including robust kernel regression and random forest regressors, to calculate a vessel lumen narrowing score by comparing actual lumen radii to estimated healthy radii, effectively addressing the challenge of non-focal stenoses and improving detection accuracy.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If quantitative coronary angiography (QCA) is used to measure percent stenosis, then measurement precision is improved, but the procedure becomes invasive and time-consuming

Engineering Contradiction:
Improvepercent stenosis measurementVSAvoidinvasiveness and time consumption
Core Design Contradiction:
Measurement precisionVSEase of operation

Solution Approach 1:

The patent uses cCTA imaging to create a non-invasive copy or representation of the coronary artery anatomy, allowing percent stenosis measurement without requiring invasive QCA procedures. The cCTA provides a virtual model that can be analyzed to determine lumen diameter and stenosis extent, replacing the need for actual catheter-based measurements while maintaining diagnostic accuracy

Inventive Principle:
Principle #26Copying

Solution Approach 2:

The patent replaces the mechanical invasive QCA system with a non-invasive computational imaging approach. Instead of using physical catheters and mechanical measurement tools inside the artery, the system uses cCTA images and automated image processing algorithms to measure lumen diameter and calculate percent stenosis, eliminating the need for invasive mechanical intervention

Inventive Principle:
Principle #28Mechanics substitution (Replace mechanical system)

2Measurement precision

If traditional methods are used to estimate healthy lumen diameter, then simplicity is maintained, but accuracy deteriorates in diffuse, ostial, and bifurcation lesions

Engineering Contradiction:
Improvehealthy lumen diameter estimationVSAvoidcomplexity of estimation method
Core Design Contradiction:
Measurement precisionVSDevice complexity

Solution Approach 1:

The patent performs preliminary segmentation of the coronary artery lumen from cCTA images before stenosis measurement. By pre-processing the images to create accurate lumen masks and centerlines, the system establishes a foundation for precise diameter measurement. This preliminary segmentation step enables accurate healthy lumen diameter estimation even in complex lesion types where traditional methods fail

Inventive Principle:
Principle #10Preliminary action

Solution Approach 2:

The patent introduces an intermediary reference vessel diameter derived from population-based data and anatomical models. Instead of directly measuring healthy diameter in็—…ๅ˜ areas where it's ambiguous, the system uses reference values from healthy vessels of similar size and location as intermediaries to estimate the expected healthy diameter, which then serves as the denominator for percent stenosis calculation

Inventive Principle:
Principle #24Intermediary (Mediator)

3Measurement precision

If manual core lab analysis is performed for percent stenosis determination, then measurement precision is improved, but productivity decreases due to time consumption

Engineering Contradiction:
Improvepercent stenosis determinationVSAvoidanalysis speed
Core Design Contradiction:
Measurement precisionVSProductivity

Solution Approach 1:

The patent implements an automated system that performs percent stenosis measurement without requiring manual core lab analysis. The system automatically segments the lumen, identifies the stenotic segment, measures diameters, and calculates percent stenosis from cCTA images. This self-service automation eliminates the need for time-consuming manual measurements by radiologists or core lab personnel while maintaining measurement accuracy

Inventive Principle:
Principle #25Self-service

Solution Approach 2:

The patent employs advanced image processing algorithms and computational methods that accelerate the analysis process. By using automated detection algorithms, machine learning models, and efficient computational geometry methods, the system rapidly processes cCTA images to determine percent stenosis, dramatically increasing productivity compared to manual analysis while preserving measurement precision

Inventive Principle:
Principle #38Strong oxidants (Accelerated oxidation)

Data Source

PatentEP4162870B1System and method for estimating a healthy lumen diameter and stenosis quantification in coronary arteries
Publication Date: 2024.01.31 HEARTFLOW INC
  • EP4162870B1 patent drawingFigure 1
  • EP4162870B1 patent drawingFigure 2A
  • EP4162870B1 patent drawingFigure 2B

AI summary

A computer-implemented method of identifying a healthy lumen diameter of a vasculature, the method comprising: receiving (301) a data set including one or more lumen segmentations of known healthy vessel segments of a population of individuals; splitting (303) each of the lumen segmentations of the population of individuals into stem-crown-root units; for each stem-crown-root unit, extracting (305) one or more features selected in a list comprising: lumen local diameter using maximum inscribed spheres, and lumen planar area; comparing (307) features from the crown and root units to features of the stem unit, by a machine learning algorithm, to infer healthy lumen diameter at the stem; and using (309) a random forest regressor to determine a population-based healthy lumen diameter for the stem based on the comparison of features.