Abstract
Background: Atherosclerotic plaques are the major cause of coronary artery disease (CAD). Currently, computed tomography (CT) is the most commonly applied imaging technique in the diagnosis of CAD. However, the accurate extraction of coronary plaque geometry from CT images is still challenging.Summary of Review: In this review, we focused on the methods in recent studies on the CT-based coronary plaque extraction. According to the dimension of plaque extraction method, the studies were categorized into two-dimensional (2D) and three-dimensional (3D) ones. In each category, the studies were analyzed in terms of data, methods, and evaluation. We summarized the merits and limitations of current methods, as well as the future directions for efficient and accurate extraction of coronary plaques using CT imaging.Conclusion: The methodological innovations are important for more accurate CT-based assessment of coronary plaques in clinical applications. The large-scale studies, de-blooming algorithms, more standardized datasets, and more detailed classification of non-calcified plaques could improve the accuracy of coronary plaque extraction from CT images. More multidimensional geometric parameters can be derived from the 3D geometry of coronary plaques. Additionally, machine learning and automatic 3D reconstruction could improve the efficiency of coronary plaque extraction in future studies.
Highlights
With the increasing incidence, coronary artery disease (CAD) is the most common type of heart disease and the leading cause of death globally (1)
The stenosis of coronary arteries incurred by the growth of atherosclerotic plaques is the major cause of CAD and related cardiac events such as acute myocardial infarctions (MI) (2)
The anatomic severity of coronary plaques estimated by computerized tomography (CT) imaging was in accordance with the results derived from intravascular ultrasound (IVUS) imaging (3)
Summary
Coronary artery disease (CAD) is the most common type of heart disease and the leading cause of death globally (1). The stenosis of coronary arteries incurred by the growth of atherosclerotic plaques is the major cause of CAD and related cardiac events such as acute myocardial infarctions (MI) (2). The accurate evaluation of atherosclerotic plaques in coronary arteries is important for the diagnosis and treatment of CAD. Cardiac or cardiovascular CT (CCT), named as coronary computed tomography angiography (CCTA, sometimes short as coronary CTA), or CT coronary angiography (CTCA), has a high spatial resolution to reflect the anatomic severity and morphology of coronary plaques. Non-calcified, partially calcified, and calcified plaques could be differentiated based on their x-ray attenuation values (in Hounsfield units, or HU) which reflect the brightness of certain areas in CT images (6). Computed tomography (CT) is the most commonly applied imaging technique in the diagnosis of CAD. The accurate extraction of coronary plaque geometry from CT images is still challenging
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