Cascade of U-Nets in the detection and classification of coronary artery calcium in thoracic low-dose CT

Jordan D. Fuhrman, Rowena Yip, Artit C. Jirapatnakul, Claudia I. Henschke, David F. Yankelevitz, Maryellen L. Giger

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review

1 Scopus citations


Low-dose thoracic CT (LDCT) screening has provided a low risk method of obtaining useful clinical information with lower quality images. Coronary artery calcium (CAC), a major indicator of cardiovascular disease, can be visualized on LDCT images. Additionally, the U-Net architecture has shown outstanding performance in a variety of medical imaging tasks, including image segmentation. Thus, the purpose of this study is to analyze the potential of the U-Net in the classification and localization of CAC in LDCT images. This study was performed with 814 LDCT cases with radiologist-determined CAC severity scores. A total of 3 truth masks per image were manually created for training of 3 U-Nets that were used to define the CAC search region, identify CAC candidates, and eliminate false positives (namely, aortic valve calcifications). Additionally, a single network tasked with only CAC candidate identification was tested to assess the need for different sections of the cascade of U-Nets. All CAC segmentation tasks were assessed using ROC analysis in the task of determining whether or not a case contained any CAC. The area under the ROC curve (AUC) as a performance metric and preliminary analysis showed potential for extension to a full classification task. CAC detection through the total cascade of 3 networks achieved and AUC of 0.97 +/- 0.01. Overall, this study shows significant promise in the localization and classification of CAC in LDCT images using a cascade of U-Nets.

Original languageEnglish
Title of host publicationMedical Imaging 2020
Subtitle of host publicationComputer-Aided Diagnosis
EditorsHorst K. Hahn, Maciej A. Mazurowski
ISBN (Electronic)9781510633957
StatePublished - 2020
EventMedical Imaging 2020: Computer-Aided Diagnosis - Houston, United States
Duration: 16 Feb 202019 Feb 2020

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISSN (Print)1605-7422


ConferenceMedical Imaging 2020: Computer-Aided Diagnosis
Country/TerritoryUnited States


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