Skip to main content

Predicting Coronary Artery Calcium Score from Retinal Fundus Photographs Using Convolutional Neural Networks

  • Conference paper
  • First Online:
Artificial Intelligence and Soft Computing (ICAISC 2020)

Part of the book series: Lecture Notes in Computer Science ((LNAI,volume 12415))

Included in the following conference series:

Abstract

Coronary Artery Calcium Score (CACS) is a prognostic indicator for coronary atherosclerosis that can cause a stroke or heart attack. Cardiac computed tomography (CT) is widely used to calculate CACS. For asymptomatic patients, however, a CT-based screening tes is not recommended due to an unnecessary exposure to radiation and high cost. In this paper, we propose a deep learning approach to predict CACS from retinal fundus photographs. Our approach is non-invasive and can observe blood vessels without any side effects. Contrasted to other approaches, we can predict CACS directly using only retinal fundus photographs without the electronic health record (EHR) data. To overcome data deficiency, we train deep convolutional neural nets (CNNs) with retinal fundus images for predicting auxiliary EHR data related to CACS. In addition, we employ a task-specific augmentation method that resolves flare phenomenon typically occurred in a retinal fundus image. Our empirical results indicate that the use of auxiliary EHR data improves the CACS prediction performance by 4.2%, and flare augmentation by 2.4% on area under the ROC curve (AUC). Applying both methods results in an overall 6.2% improvement. In the light of feature extraction and inference uncertainty, our deep learning models can predict CACS using only retinal fundus images and identify individuals with a cardiovascular disease.

S. Cho–First author

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Agatston, A.S., Janowitz, W.R., Hildner, F.J., Zusmer, N.R., Viamonte, M., Detrano, R.: Quantification of coronary artery calcium using ultrafast computed tomography. J. Am. Coll. Cardiol. 15(4), 827–832 (1990)

    Article  Google Scholar 

  2. Alluri, K., Joshi, P.H., Henry, T.S., Blumenthal, R.S., Nasir, K., Blaha, M.J.: Scoring of coronary artery calcium scans: history, assumptions, current limitations, and future directions. Atherosclerosis 239(1), 109–117 (2015)

    Article  Google Scholar 

  3. Blaha, M.J.: Personalizing treatment: between primary and secondary prevention. Am. J. Cardiol. 118(6), 4A–12A (2016)

    Article  Google Scholar 

  4. Brahim, A.B., Limam, M.: Ensemble feature selection for high dimensional data: a new method and a comparative study. Adv. Data Anal. Classif. 12(4), 937–952 (2018)

    Article  MathSciNet  Google Scholar 

  5. Budoff, M.J., et al.: Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the american heart association committee on cardiovascular imaging and intervention, council on cardiovascular radiology and intervention, and committee on cardiac imaging, council on clinical cardiology. Circulation 114(16), 1761–1791 (2006)

    Article  Google Scholar 

  6. Burlina, P.M., Joshi, N., Pekala, M., Pacheco, K.D., Freund, D.E., Bressler, N.M.: Automated grading of age-related macular degeneration from color fundus images using deep convolutional neural networks. JAMA Ophthalmol. 135(11), 1170–1176 (2017)

    Article  Google Scholar 

  7. Curry, S.J., et al.: Risk assessment for cardiovascular disease with nontraditional risk factors: us preventive services task force recommendation statement. JAMA 320(3), 272–280 (2018)

    Article  Google Scholar 

  8. Gal, Y.: Uncertainty in deep learning. Ph.D. thesis, University of Cambridge (2016)

    Google Scholar 

  9. Greenland, P., Blaha, M.J., Budoff, M.J., Erbel, R., Watson, K.E.: Coronary calcium score and cardiovascular risk. J. Am. Coll. Cardiol. 72(4), 434–447 (2018)

    Article  Google Scholar 

  10. Gulshan, V., et al.: Development and validation of a deep learning algorithm for detection of diabetic retinopathy in retinal fundus photographs. JAMA 316(22), 2402–2410 (2016)

    Article  Google Scholar 

  11. Jellinger, P.S., et al.: American association of clinical endocrinologists and American college of endocrinology guidelines for management of dyslipidemia and prevention of cardiovascular disease. Endocr. Pract. 23(s2), 1–87 (2017)

    Article  Google Scholar 

  12. Krizhevsky, A., Sutskever, I., Hinton, G.E.: ImageNet classification with deep convolutional neural networks. In: Advances in Neural Information Processing Systems, pp. 1097–1105 (2012)

    Google Scholar 

  13. Lessmann, N., et al.: Automatic calcium scoring in low-dose chest CT using deep neural networks with dilated convolutions. IEEE Trans. Med. Imaging 37(2), 615–625 (2017)

    Article  Google Scholar 

  14. Li, Z., He, Y., Keel, S., Meng, W., Chang, R.T., He, M.: Efficacy of a deep learning system for detecting glaucomatous optic neuropathy based on color fundus photographs. Ophthalmology 125(8), 1199–1206 (2018)

    Article  Google Scholar 

  15. McClintic, B.R., McClintic, J.I., Bisognano, J.D., Block, R.C.: The relationship between retinal microvascular abnormalities and coronary heart disease: a review. Am. J. Med. 123(4), 374 e1–374 e7 (2010)

    Article  Google Scholar 

  16. Poplin, R., et al.: Prediction of cardiovascular risk factors from retinal fundus photographs via deep learning. Nature Biomed. Eng. 2(3), 158 (2018)

    Article  Google Scholar 

  17. Saeys, Y., Abeel, T., Van de Peer, Y.: Robust feature selection using ensemble feature selection techniques. In: Daelemans, W., Goethals, B., Morik, K. (eds.) ECML PKDD 2008. LNCS (LNAI), vol. 5212, pp. 313–325. Springer, Heidelberg (2008). https://doi.org/10.1007/978-3-540-87481-2_21

    Chapter  Google Scholar 

  18. Santini, G., et al.: An automatic deep learning approach for coronary artery calcium segmentation. EMBEC/NBC -2017. IP, vol. 65, pp. 374–377. Springer, Singapore (2018). https://doi.org/10.1007/978-981-10-5122-7_94

    Chapter  Google Scholar 

  19. Szegedy, C., Vanhoucke, V., Ioffe, S., Shlens, J., Wojna, Z.: Rethinking the inception architecture for computer vision. In: Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition, pp. 2818–2826 (2016)

    Google Scholar 

  20. Tabatabaee, A., Asharin, M., Dehghan, M., Pourbehi, M., Nasiri-Ahmadabadi, M., Assadi, M.: Retinal vessel abnormalities predict coronary artery diseases. Perfusion 28(3), 232–237 (2013)

    Article  Google Scholar 

  21. Wang, J.J., et al.: Retinal vessel diameter and cardiovascular mortality: pooled data analysis from two older populations. Eur. Heart J. 28(16), 1984–1992 (2007)

    Article  Google Scholar 

  22. Wong, T.Y., et al.: Relation of retinopathy to coronary artery calcification: the multi-ethnic study of atherosclerosis. Am. J. Epidemiol. 167(1), 51–58 (2007)

    Article  Google Scholar 

  23. World Health Organisation: Fact sheet cardiovascular diseases (CVDS) (2017)

    Google Scholar 

  24. Xu, K., et al.: Show, attend and tell: neural image caption generation with visual attention. In: International Conference on Machine Learning, pp. 2048–2057 (2015)

    Google Scholar 

Download references

Acknowledgement

We thank Youngjune Gwon (Vice President, Samsung SDS) for improving the manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to JoonHo Lee .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this paper

Check for updates. Verify currency and authenticity via CrossMark

Cite this paper

Cho, S. et al. (2020). Predicting Coronary Artery Calcium Score from Retinal Fundus Photographs Using Convolutional Neural Networks. In: Rutkowski, L., Scherer, R., Korytkowski, M., Pedrycz, W., Tadeusiewicz, R., Zurada, J.M. (eds) Artificial Intelligence and Soft Computing. ICAISC 2020. Lecture Notes in Computer Science(), vol 12415. Springer, Cham. https://doi.org/10.1007/978-3-030-61401-0_56

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-61401-0_56

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-61400-3

  • Online ISBN: 978-3-030-61401-0

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics