# Automated Segmentation and Volume Measurement of Intracranial Carotid Artery Calcification on Non-Contrast CT

arXiv: https://arxiv.org/abs/2107.09442 · HTML: https://mlsanity.com/paper/2107.09442/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 7 of its 31 references that are in the map.
- First posted on arXiv 20 Jul 2021.

## Builds on (most cited first, 7 of 7)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Domain-Adversarial Training of Neural Networks](https://mlsanity.com/paper/1505.07818/) (2015)
- [A Survey on Deep Learning in Medical Image Analysis](https://mlsanity.com/paper/1702.05747/) (2017)
- [Generalised Dice overlap as a deep learning loss function for highly unbalanced segmentations](https://mlsanity.com/paper/1707.03237/) (2017)
- [Ensembles of Multiple Models and Architectures for Robust Brain Tumour Segmentation](https://mlsanity.com/paper/1711.01468/) (2017)
- [Automatic calcium scoring in low-dose chest CT using deep neural networks with dilated convolutions](https://mlsanity.com/paper/1711.00349/) (2017)
- [Segmentation of Intracranial Arterial Calcification with Deeply Supervised Residual Dropout Networks](https://mlsanity.com/paper/1706.01148/) (2017)

## Built on by (most cited first, 1 of 1)

- [Depth-Sequence Transformer (DST) for Segment-Specific ICA Calcification Mapping on Non-Contrast CT](https://mlsanity.com/paper/2507.08214/) (2025)

## Abstract (arXiv)

Purpose: To evaluate a fully-automated deep-learning-based method for assessment of intracranial carotid artery calcification (ICAC). Methods: Two observers manually delineated ICAC in non-contrast CT scans of 2,319 participants (mean age 69 (SD 7) years; 1154 women) of the Rotterdam Study, prospectively collected between 2003 and 2006. These data were used to retrospectively develop and validate a deep-learning-based method for automated ICAC delineation and volume measurement. To evaluate the method, we compared manual and automatic assessment (computed using ten-fold cross-validation) with respect to 1) the agreement with an independent observer's assessment (available in a random subset of 47 scans); 2) the accuracy in delineating ICAC as judged via blinded visual comparison by an expert; 3) the association with first stroke incidence from the scan date until 2012. All method performance metrics were computed using 10-fold cross-validation. Results: The automated delineation of ICAC reached sensitivity of 83.8% and positive predictive value (PPV) of 88%. The intraclass correlation between automatic and manual ICAC volume measures was 0.98 (95% CI: 0.97, 0.98; computed in the entire dataset). Measured between the assessments of independent observers, sensitivity was 73.9%, PPV was 89.5%, and intraclass correlation was 0.91 (95% CI: 0.84, 0.95; computed in the 47-scan subset). In the blinded visual comparisons, automatic delineations were more accurate than manual ones (p-value = 0.01). The association of ICAC volume with incident stroke was similarly strong for both automated (hazard ratio, 1.38 (95% CI: 1.12, 1.75) and manually measured volumes (hazard ratio, 1.48 (95% CI: 1.20, 1.87)). Conclusions: The developed model was capable of automated segmentation and volume quantification of ICAC with accuracy comparable to human experts.