Aortic atherosclerosis evaluation using deep learning based on non-contrast CT: A retrospective multi-center study

Summary: Non-contrast CT (NCCT) is widely used in clinical practice and holds potential for large-scale atherosclerosis screening, yet its application in detecting and grading aortic atherosclerosis remains limited. To address this, we propose Aortic-AAE, an automated segmentation system based on a...

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Main Authors: Mingliang Yang, Jinhao Lyu, Yongqin Xiong, Aoxue Mei, Jianxing Hu, Yue Zhang, Xiaoyu Wang, Xiangbing Bian, Jiayu Huang, Runze Li, Xinbo Xing, Sulian Su, Junhang Gao, Xin Lou
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:iScience
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Online Access:http://www.sciencedirect.com/science/article/pii/S2589004225013616
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Summary:Summary: Non-contrast CT (NCCT) is widely used in clinical practice and holds potential for large-scale atherosclerosis screening, yet its application in detecting and grading aortic atherosclerosis remains limited. To address this, we propose Aortic-AAE, an automated segmentation system based on a cascaded attention mechanism within the nnU-Net framework. The cascaded attention module enhances feature learning across complex anatomical structures, outperforming existing attention modules. Integrated preprocessing and post-processing ensure anatomical consistency and robustness across multi-center data. Trained on 435 labeled NCCT scans from three centers and validated on 388 independent cases, Aortic-AAE achieved 81.12% accuracy in aortic stenosis classification and 92.37% in Agatston scoring of calcified plaques, surpassing five state-of-the-art models. This study demonstrates the feasibility of using deep learning for accurate detection and grading of aortic atherosclerosis from NCCT, supporting improved diagnostic decisions and enhanced clinical workflows.
ISSN:2589-0042