Media-adventitia Border Research Articles

A deep learning-based calculation system for plaque stenosis severity on common carotid artery of ultrasound images.

Assessment of plaque stenosis severity allows better management of carotid source of stroke. Our objective is to create a deep learning (DL) model to segment carotid intima-media thickness and plaque and further automatically calculate plaque stenosis severity on common carotid artery (CCA) transverse section ultrasound images. Three hundred and ninety images from 376 individuals were used to train (235/390, 60%), validate (39/390, 10%), and test (116/390, 30%) on a newly proposed CANet model. We also evaluated the model on an external test set of 115 individuals with 122 images acquired from another hospital. Comparative studies were conducted between our CANet model with four state-of-the-art DL models and two experienced sonographers to re-evaluate the present model's performance. On the internal test set, our CANet model outperformed the four comparative models with Dice values of 95.22% versus 90.15%, 87.48%, 90.22%, and 91.56% on lumen-intima (LI) borders and 96.27% versus 91.40%, 88.94%, 91.19%, and 92.88% on media-adventitia (MA) borders. On the external test set, our model still produced excellent results with a Dice value of 92.41%. Good consistency of stenosis severity calculation was observed between CANet model and experienced sonographers, with Intraclass Correlation Coefficient (ICC) of 0.927 and 0.702, Pearson's Correlation Coefficient of 0.928 and 0.704 on internal and external test set, respectively. Our CANet model achieved excellent performance in the segmentation of carotid IMT and plaques as well as automated calculation of stenosis severity.

Extraction of media adventitia and luminal intima borders by reconstructing intravascular ultrasound image sequences with vascular structural continuity.

Most published methods directly achieve vessel membrane border detection on cross-sectional intravascular ultrasound (IVUS) images. The vascular structural continuity that exists in entire IVUS image sequences has been overlooked. However, this continuity can have a helpful role in the delineation of vessel membrane contours. To achieve the vessel membrane segmentation more effectively through employing this continuity, a strategy, referred to as multiangle reconstruction, segmentation, and recovery (RSR), is proposed in this paper. Four main steps are contained in the multiangle-RSR: first, a combination of sampling and interpolation is employed to reconstruct long-axis-model IVUS frames, in which continuity information becomes available. Second, a clustering algorithm is conducted on long-axis-model IVUS frames to roughly extract the media-adventitia (MA) and lumen-intima (LI) boundaries. Third, the segmentation results of cross-sectional IVUS frames are recovered based on the rough results of long-axis-model IVUS frames, and an optimization process that combines downsampling, fitting and smoothing is designed to reduce the interference of bifurcation and side vessels. Multiangle-RSR is tested on a public dataset, and the Hausdorff distance (HD), Jaccard measure (JM), and percentage of area difference (PAD) are utilized as quantitative evaluation metrics. Mean HDs of 0.34 and 0.29mm are obtained for MA border detection and LI border detection, respectively, which decrease by 43.3% and 9.4%, respectively, compared with their counterparts in previously published approaches. Furthermore, the mean JM is 0.87 for both MA border detection and LI border detection. The mean PADs of the MA contour extraction and the LI contour extraction are 0.10 and 0.11, respectively. The results indicate that the proposed strategy effectively introduces vascular structural continuity by reconstructing long-axis-model IVUS frames and achieves more precise extraction of MA and LI borders.

Age-related carotid extra-media thickening is associated with increased blood pressure and arterial stiffness.

Ageing results in higher blood pressure and arterial stiffening leading to increased cardiovascular disease (CVD) risk. The extra-media thickness (EMT) is a composite measure of the arterial adventitia, perivascular adipose tissue (PVAT) and the jugular vein, but the association among EMT and ageing, blood pressure and arterial stiffness is largely unknown. We hypothesized that EMT is associated with ageing, blood pressure and arterial stiffness. Fifty (18M/32F, age range 20-79years.) individuals underwent measures of EMT (media-adventitia border to jugular lumen interface) via ultrasonography, blood pressure (brachial; carotid), arterial stiffness (carotid beta-stiffness, distensibility and Young's modulus) and body composition (dual X-ray absorptiometry). Independent two-tailed t-tests compared characteristics between young and middle-aged/older adults (MA/O). Bivariate correlations assessed the relation between EMT, ageing, blood pressure and arterial stiffness endpoints. Partial correlations were used to adjust for age, sex, body mass index (BMI) and body fat percentage. Compared to young, MA/O adults had higher EMT, blood pressure, arterial stiffness, BMI and BF% (all, p≤0.05). Carotid EMT was positively correlated with age (r=0.46), brachial SBP (r=0.32), carotid SBP (r=0.42), PP (r=0.42), beta-stiffness (r=0.37) and Young's elastic modulus (r=0.43) (all, p≤0.05), and negatively correlated with carotid distensibility (r=-0.34, p≤0.05). All endpoints correlated with EMT remained after adjusting for BMI, BF% and sex (p≤0.05). These data suggest EMT is a clinically relevant target that may be associated with age-related CVD risk in humans, yet further investigation is required to elucidate the role of EMT in age-related increases in blood pressure and arterial stiffness.

Deep learning-based intravascular ultrasound segmentation for the assessment of coronary artery disease

BackgroundAccurate segmentation of the coronary arteries with intravascular ultrasound (IVUS) is important to optimize coronary stent implantation. Recently, deep learning (DL) methods have been proposed to develop automatic IVUS segmentation. However, most of those have been limited to segmenting the lumen and vessel (i.e. lumen-intima and media-adventitia borders), not applied to segmenting stent dimension. Hence, this study aimed to develop a DL method for automatic IVUS segmentation of stent area in addition to lumen and vessel area. MethodsThis study included a total of 45,449 images from 1576 IVUS pullback runs. The datasets were randomly split into training, validation, and test datasets (0.7:0.15:0.15). After developing the DL-based system to segment IVUS images using the training and validation datasets, we evaluated the performance through the independent test dataset. ResultsThe DL-based segmentation correlated well with the expert-analyzed segmentation with a mean intersection over union (± standard deviation) of 0.80 ± 0.20, correlation coefficient of 0.98 (95% confidence intervals: 0.98 to 0.98), 0.96 (0.95 to 0.96), and 0.96 (0.96 to 0.96) for lumen, vessel, and stent area, and the mean difference (± standard deviation) of 0.02 ± 0.57, −0.44 ± 1.56 and − 0.17 ± 0.74 mm2 for lumen, vessel and stent area, respectively. ConclusionThis automated DL-based IVUS segmentation of lumen, vessel and stent area showed an excellent agreement with manual segmentation by experts, supporting the feasibility of artificial intelligence-assisted IVUS assessment in patients undergoing coronary stent implantation.

Automatic Detection of Atherosclerotic Plaque and Calcification From Intravascular Ultrasound Images by Using Deep Convolutional Neural Networks.

Atherosclerosis is the major cause of cardiovascular diseases (CVDs). Intravascular ultrasound (IVUS) is a common imaging modality for diagnosing CVDs. However, an efficient analyzer for IVUS image segmentation is required for assisting cardiologists. In this study, an end-to-end deep-learning convolutional neural network was developed for automatically detecting media-adventitia borders, luminal regions, and calcified plaque in IVUS images. A total of 713 grayscale IVUS images from 18 patients were used as training data for the proposed deep-learning model. The model is constructed using the three modified U-Nets and combined with the concept of cascaded networks to prevent errors in the detection of calcification owing to the interference of pixels outside the plaque regions. Three loss functions (Dice, Tversky, and focal loss) with various characteristics were tested to determine the best setting for the proposed model. The efficacy of the deep-learning model was evaluated by analyzing precision-recall curve. The average precision (AP), Dice score coefficient, precision, sensitivity, and specificity of the predicted and ground truth results were then compared. All training processes were validated using leave-one-subject-out cross-validation. The experimental results showed that the proposed deep-learning model exhibits high performance in segmenting the media-adventitia layers and luminal regions for all loss functions, with all tested metrics being higher than 0.90. For locating calcified tissues, the best result was obtained when the focal loss function was applied to the proposed model, with an AP of 0.73; however, the prediction efficacy was affected by the proportion of calcified tissues within the plaque region when the focal loss function was employed. Compared with commercial software, the proposed method exhibited high accuracy in segmenting IVUS images in some special cases, such as when shadow artifacts or side vessels surrounded the target vessel.

Extracting Membrane Borders in IVUS Images Using a Multi-Scale Feature Aggregated U-Net.

Automatic extraction of the lumen-intima border (LIB) and the media-adventitia border (MAB) in intravascular ultrasound (IVUS) images is of high clinical interest. Despite the superior performance achieved by deep neural networks (DNNs) on various medical image segmentation tasks, there are few applications to IVUS images. The complicated pathological presentation and the lack of enough annotation in IVUS datasets make the learning process challenging. Several existing networks designed for IVUS segmentation train two groups of weights to detect the MAB and LIB separately. In this paper, we propose a multi-scale feature aggregated U-Net (MFAU-Net) to extract two membrane borders simultaneously. The MFAU-Net integrates multi-scale inputs, the deep supervision, and a bi-directional convolutional long short-term memory (BConvLSTM) unit. It is designed to sufficiently learn features from complicated IVUS images through a small number of training samples. Trained and tested on the publicly available IVUS datasets, the MFAU-Net achieves both 0.90 Jaccard measure (JM) for the MAB and LIB detection on 20 MHz dataset. The corresponding metrics on 40 MHz dataset are 0.85 and 0.84 JM respectively. Comparative evaluations with state-of-the-art published results demonstrate the competitiveness of the proposed MFAU-Net.

Performance Assessment of K-Means and KNN Algorithm for the Detection of Borders and Extraction of Plaque Area from IVUS Images

The coronary artery vascular disease of atherosclerosis, which made the blood vessel artery wall harden and narrow. The vascular wall disease quantitatively analyzed and diagnosed by an intravascular ultrasound (IVUS) image. The quantitative investigations of coronary atherosclerosis by means of IVUS and manual recognition of wall and plaque borders are restricted by the need for observers with considerable understanding and the tedious environment of manual border detection. To improve and provide more detailed vessel and plaque information for better diagnosis and assessment go for an automated segmentation. An automated construction for the purpose of perceiving lumen and media-adventitia borders in IVUS images was effectively formulated. An effectual unsupervised K-Means clustering scheme refine the borders with morphological operations, later an IVUS data samples area classified using supervised KNN(K-Nearest Neighbor) classifier to extract the plaque feature. The performance of contour metric measurements in terms of Jaccard Index (JI), percentage area difference (PAD), area error (AE), dice index (DI), false positive ratio (RFP), in addition to false negative ratio (RFN) are computed for evaluation and variation.

IVUS Image Segmentation Using Superpixel-Wise Fuzzy Clustering and Level Set Evolution

Reliable detection of the media-adventitia border (MAB) and the lumen-intima border (LIB) in intravascular ultrasound (IVUS) images remains a challenging task that is of high clinical interest. In this paper, we propose a superpixel-wise fuzzy clustering technique modified by edges, followed by level set evolution (SFCME-LSE), for automatic border extraction in 40 MHz IVUS images. The contributions are three-fold. First, the usage of superpixels suppresses the influence of speckle noise in ultrasound images on the clustering results. Second, we propose a region of interest (ROI) assignment scheme to prevent the segmentation from being distracted by pathological structures and artifacts. Finally, the contour is converged towards the target boundary through LSE with an appropriately improved edge indicator. Quantitative evaluations on two IVUS datasets by the Jaccard measure (JM), the percentage of area difference (PAD), and the Hausdorff distance (HD) demonstrate the effectiveness of the proposed SFCME-LSE method. SFCME-LSE achieves the minimal HD of 1.20 ± 0.66 mm and 1.18 ± 0.70 mm for the MAB and LIB, respectively, among several state-of-the-art methods on a publicly available dataset.

IVUS images segmentation using spatial fuzzy clustering and hierarchical level set evolution

The detection of the lumen and media-adventitia (MA) borders in intravascular ultrasound (IVUS) images is crucial for quantifying plaque burdens. The challenge of the segmentation work mainly roots in various artifacts in the image. Most of the published methods involve the establishment of complex models but do not behave well on images with artifacts. In this study, aiming at automatically delineating borders in IVUS frames acquired by 20 MHz ultrasound probes, we present a fuzzy clustering-initialized hierarchical level set evolution (FC-HLSE) method. A cluster selection strategy based on the spatial fuzzy c-means (FCM) is proposed to generate the initial value and regularization term of the level set evolution (LSE). The contour convergence splits into two LSE steps between which an ingenious contour extraction (consisting of the morphological processing, the seek and linear interpolation, the gradient-based and circular fitting-based refinement) is carried out. We evaluate the proposed methodology on the publicly available 435 images by comparing auto-segmented results with the ground truth. The performance of the method is quantified using the Jaccard measure (JM), the Hausdorff distance (HD), the percentage of area difference (PAD), the linear regression and Bland-Altman analysis. Results reveal that our method can handle images with or without artifacts. The algorithm is able to extract the lumen/MA border with the JM of 0.90/0.89, the HD of 0.31/0.40 mm, the PAD of 0.07/0.08 in average, which is better in some cases compared with several state-of-the-art methods.

Detecting the Media-adventitia Border in Intravascular Ultrasound Images through a Classification-based Approach.

The detection of the media-adventitia (MA) border in intravascular ultrasound (IVUS) images is essential for vessel assessment and disease diagnosis. However, it remains a challenging task, considering the existence of plaque, calcification, and various artifacts. In this article, an effective method based on classification is proposed to extract the MA border in IVUS images. First, a novel morphologic feature describing the relative position of each structure relative to the MA border, called RPES for short, is proposed. Then, the RPES feature and other features are employed in a multiclass extreme learning machine (ELM) to classify IVUS images into nine classes including the MA border and other structures. At last, a modified snake model is employed to effectively detect the MA border in the rectangular domain, in which a modified external force field is constructed on the basis of local border appearances and classification results. The proposed method is evaluated on a public dataset with 77 IVUS images by three indicators in eight situations, such as calcification and a guide wire artifact. With the proposed RPES feature, detection performances are improved by more than 39 percent, which shows an apparent advantage in comparative experiments. Furthermore, compared with two other existing methods used on the same dataset, the proposed method achieves 18 of the best indicators among 24, demonstrating its higher capability in detecting the MA border.

A new nonparametric statistical approach to detect lumen and Media-Adventitia borders in intravascular ultrasound frames

Intravascular ultrasound (IVUS) imaging is widely known as a powerful interventional imaging modality for diagnosing atherosclerosis, and for treatment planning. In this regard, the detection of lumen and media–adventitia (MA) borders is considered to be a vital process. However, the manual detection of these two borders by the physician is cumbersome due to the large number of frames in a sequence. In addition, no approved universal automatic method has been presented so far due to the great diversity in the appearance of the coronary artery in the images acquired by different IVUS systems. To this end, the present study aimed to provide a new border search theory on the radial profile, based upon the nonparametric statistical approach, and to develop a generic and fully automatic three-step process for extracting the lumen and MA borders in IVUS frames based on the proposed theory. Thereafter, the proposed theory and three-step process were evaluated on synthetic images, as well as on a test set of standard publicly available images, respectively. The results showed that our three-step process could segment the borders with ≥0.82 and with ≥0.75 Jaccard measure (JM) to manual borders in IVUS frames acquired by the 20 MHz and 40 MHz probes, respectively. Based on the results, the lumen and MA borders can be extracted automatically, and the border extraction process can be implemented in parallel for a polar image due to the capability of the present proposed method to estimate the borders for each angle independently.

Fractional-order Darwinian PSO-based feature selection for media-adventitia border detection in intravascular ultrasound images

Media-adventitia (MA) border delineates the outer appearance of arterial wall in intravascular ultrasound (IVUS) image. The detection of MA border is a challenging topic due to many difficulties such as complicated intravascular structures, intrinsic artifacts and image noises. We propose a classification-based MA border detection method with an embedded feature selection technique. The feature selection technique is based on Fractional-order Darwinian particle swarm optimization (FODPSO) algorithm. By employing feature selection, 293-dimension features including multi-scale features, gray-scale features and morphological feature are reducing to 37-dimension. The border detection method with feature selection is tested on a public dataset extracted from in-vivo pullbacks of human coronary arteries, which contains 77 IVUS images. Three indicators, Jaccard (JACC), Hausdorff Distance (HD) and Percentage of Area Difference (PAD), are measured for quantitative evaluation. Detection with 293-dimension features obtains JACC 0.79, HD 1.41 and PAD 0.16, while detection with 37-dimension features obtains JACC 0.83, HD 1.27 and PAD 0.12, indicating that the FODPSO-based feature selection method improves MA border detection by JACC 0.04, HD 0.14 and PAD 0.04. Furthermore, the proposed border detection method acquires better performances compared with two other automatic methods conducted on the same dataset available in literature.

Deep learning strategy for accurate carotid intima-media thickness measurement: An ultrasound study on Japanese diabetic cohort

MotivationThe carotid intima-media thickness (cIMT) is an important biomarker for cardiovascular diseases and stroke monitoring. This study presents an intelligence-based, novel, robust, and clinically-strong strategy that uses a combination of deep-learning (DL) and machine-learning (ML) paradigms. MethodologyA two-stage DL-based system (a class of AtheroEdge™ systems) was proposed for cIMT measurements. Stage I consisted of a convolution layer-based encoder for feature extraction and a fully convolutional network-based decoder for image segmentation. This stage generated the raw inner lumen borders and raw outer interadventitial borders. To smooth these borders, the DL system used a cascaded stage II that consisted of ML-based regression. The final outputs were the far wall lumen-intima (LI) and media-adventitia (MA) borders which were used for cIMT measurements. There were two sets of gold standards during the DL design, therefore two sets of DL systems (DL1 and DL2) were derived. ResultsA total of 396 B-mode ultrasound images of the right and left common carotid artery were used from 203 patients (Institutional Review Board approved, Toho University, Japan). For the test set, the cIMT error for the DL1 and DL2 systems with respect to the gold standard was 0.126 ± 0.134 and 0.124 ± 0.100 mm, respectively. The corresponding LI error for the DL1 and DL2 systems was 0.077 ± 0.057 and 0.077 ± 0.049 mm, respectively, while the corresponding MA error for DL1 and DL2 was 0.113 ± 0.105 and 0.109 ± 0.088 mm, respectively. The results showed up to 20% improvement in cIMT readings for the DL system compared to the sonographer's readings. Four statistical tests were conducted to evaluate reliability, stability, and statistical significance. ConclusionThe results showed that the performance of the DL-based approach was superior to the nonintelligence-based conventional methods that use spatial intensities alone. The DL system can be used for stroke risk assessment during routine or clinical trial modes.

Lumen and media-adventitia border detection in IVUS images using texture enhanced deformable model

Lumen and media–adventitia (MA) borders in intravascular ultrasound (IVUS) images are critical for assessing the dimensions of vascular structures and providing plaque information in the diagnosis and navigation of vascular interventions. However, manual delineation of the lumen and MA borders is an intricate and time-consuming process. In this paper, a texture-enhanced deformable model (TEDM) is proposed to accurately detect these borders by incorporating texture information with the morphological factors of deformable model. An ensemble support vector machine classifier is used to classify IVUS pixels presented by texture features into different tissue types. The image regionalization maps of different tissue types are further used for texture enhancement modules in the TEDM. The proposed TEDM method has been tested on 1500 images from 15 clinical IVUS datasets by comparing with the manual delineations. Evaluation results demonstrate that our method can accurately detect lumen and MA surfaces with small surface distance errors of 0.17 and 0.19 mm, respectively. Accurate segmentation results provide 2D measurements of MA/lumen areas and 3D vessel visualizations for vascular interventions.

Segmentation of arterial walls in intravascular ultrasound cross-sectional images using extremal region selection

Intravascular Ultrasound (IVUS) is an intra-operative imaging modality that facilitates observing and appraising the vessel wall structure of the human coronary arteries. Segmentation of arterial wall boundaries from the IVUS images is not only crucial for quantitative analysis of the vessel walls and plaque characteristics, but is also necessary for generating 3D reconstructed models of the artery. The aim of this study is twofold. Firstly, we investigate the feasibility of using a recently proposed region detector, namely Extremal Region of Extremum Level (EREL) to delineate the luminal and media-adventitia borders in IVUS frames acquired by 20 MHz probes. Secondly, we propose a region selection strategy to label two ERELs as lumen and media based on the stability of their textural information. We extensively evaluated our selection strategy on the test set of a standard publicly available dataset containing 326 IVUS B-mode images. We showed that in the best case, the average Hausdorff Distances (HD) between the extracted ERELs and the actual lumen and media were 0.22 mm and 0.45 mm, respectively. The results of our experiments revealed that our selection strategy was able to segment the lumen with ⩽0.3 mm HD to the gold standard even though the images contained major artifacts such as bifurcations, shadows, and side branches. Moreover, when there was no artifact, our proposed method was able to delineate media-adventitia boundaries with 0.31 mm HD to the gold standard. Furthermore, our proposed segmentation method runs in time that is linear in the number of pixels in each frame. Based on the results of this work, by using a 20 MHz IVUS probe with controlled pullback, not only can we now analyze the internal structure of human arteries more accurately, but also segment each frame during the pullback procedure because of the low run time of our proposed segmentation method.

A modified segmentation method for determination of IV vessel boundaries

Coronary heart diseases are ranked as the top diseases causing death in many countries worldwide. Intravascular Ultrasound (IVUS) directly images the vessel from inside and allows the extraction of vessel bounders and the measurement of vessel cross-sectional area. This paper introduces an approach for detection of lumen and media-adventitia borders in an Intravascular (IV) image. In the proposed method, a modified fast algorithm is applied to determine the lumen and media-adventitia contours. The modified fast algorithm is fully tested and it showed an improvement in speed of up to 200% while preserving an accuracy rate of 98%.

Automatic media-adventitia IVUS image segmentation based on sparse representation framework and dynamic directional active contour model

Segmentation of the arterial wall boundaries from intravascular ultrasound images is an important image processing task in order to quantify arterial wall characteristics such as shape, area, thickness and eccentricity. Since manual segmentation of these boundaries is a laborious and time consuming procedure, many researchers attempted to develop (semi-) automatic segmentation techniques as a powerful tool for educational and clinical purposes in the past but as yet there is no any clinically approved method in the market. This paper presents a deterministic-statistical strategy for automatic media-adventitia border detection by a fourfold algorithm. First, a smoothed initial contour is extracted based on the classification in the sparse representation framework which is combined with the dynamic directional convolution vector field. Next, an active contour model is utilized for the propagation of the initial contour toward the interested borders. Finally, the extracted contour is refined in the leakage, side branch openings and calcification regions based on the image texture patterns. The performance of the proposed algorithm is evaluated by comparing the results to those manually traced borders by an expert on 312 different IVUS images obtained from four different patients. The statistical analysis of the results demonstrates the efficiency of the proposed method in the media-adventitia border detection with enough consistency in the leakage and calcification regions.

An artificial neural network method for lumen and media-adventitia border detection in IVUS

Intravascular ultrasound (IVUS) has been well recognized as one powerful imaging technique to evaluate the stenosis inside the coronary arteries. The detection of lumen border and media-adventitia (MA) border in IVUS images is the key procedure to determine the plaque burden inside the coronary arteries, but this detection could be burdensome to the doctor because of large volume of the IVUS images. In this paper, we use the artificial neural network (ANN) method as the feature learning algorithm for the detection of the lumen and MA borders in IVUS images. Two types of imaging information including spatial, neighboring features were used as the input data to the ANN method, and then the different vascular layers were distinguished accordingly through two sparse auto-encoders and one softmax classifier. Another ANN was used to optimize the result of the first network. In the end, the active contour model was applied to smooth the lumen and MA borders detected by the ANN method. The performance of our approach was compared with the manual drawing method performed by two IVUS experts on 461 IVUS images from four subjects. Results showed that our approach had a high correlation and good agreement with the manual drawing results. The detection error of the ANN method close to the error between two groups of manual drawing result. All these results indicated that our proposed approach could efficiently and accurately handle the detection of lumen and MA borders in the IVUS images.

Basic interpretation of intracoronary ultrasound and optical coherence tomography images: examples

Basic interpretation of intracoronary ultrasound and optical coherence tomography images: examples

Automated Framework for Detecting Lumen and Media–Adventitia Borders in Intravascular Ultrasound Images

An automated framework for detecting lumen and media–adventitia borders in intravascular ultrasound images was developed on the basis of an adaptive region-growing method and an unsupervised clustering method. To demonstrate the capability of the framework, linear regression, Bland–Altman analysis and distance analysis were used to quantitatively investigate the correlation, agreement and spatial distance, respectively, between our detected borders and manually traced borders in 337 intravascular ultrasound images in vivo acquired from six patients. The results of these investigations revealed good correlation (r = 0.99), good agreement (>96.82% of results within the 95% confidence interval) and small average distance errors (lumen border: 0.08 mm, media–adventitia border: 0.10 mm) between the borders generated by the automated framework and the manual tracing method. The proposed framework was found to be effective in detecting lumen and media–adventitia borders in intravascular ultrasound images, indicating its potential for use in routine studies of vascular disease.