# Generative Models for Reproducible Coronary Calcium Scoring

arXiv: https://arxiv.org/abs/2205.11967 · HTML: https://mlsanity.com/paper/2205.11967/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 9 of its 51 references that are in the map.
- First posted on arXiv 24 May 2022.

## Builds on (most cited first, 9 of 9)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [PyTorch: An Imperative Style, High-Performance Deep Learning Library](https://mlsanity.com/paper/1912.01703/) (2019)
- [Image-to-Image Translation with Conditional Adversarial Networks](https://mlsanity.com/paper/1611.07004/) (2016)
- [Deep Autoencoding Models for Unsupervised Anomaly Segmentation in Brain MR Images](https://mlsanity.com/paper/1804.04488/) (2018)
- [Unsupervised Detection of Lesions in Brain MRI using constrained adversarial auto-encoders](https://mlsanity.com/paper/1806.04972/) (2018)
- [Visual Feature Attribution using Wasserstein GANs](https://mlsanity.com/paper/1711.08998/) (2017)
- [An Adversarial Learning Approach to Medical Image Synthesis for Lesion Detection](https://mlsanity.com/paper/1810.10850/) (2018)
- [Automatic calcium scoring in low-dose chest CT using deep neural networks with dilated convolutions](https://mlsanity.com/paper/1711.00349/) (2017)
- [Direct Automatic Coronary Calcium Scoring in Cardiac and Chest CT](https://mlsanity.com/paper/1902.05408/) (2019)

## Abstract (arXiv)

Purpose: Coronary artery calcium (CAC) score, i.e. the amount of CAC quantified in CT, is a strong and independent predictor of coronary heart disease (CHD) events. However, CAC scoring suffers from limited interscan reproducibility, which is mainly due to the clinical definition requiring application of a fixed intensity level threshold for segmentation of calcifications. This limitation is especially pronounced in non-ECG-synchronized CT where lesions are more impacted by cardiac motion and partial volume effects. Therefore, we propose a CAC quantification method that does not require a threshold for segmentation of CAC. Approach: Our method utilizes a generative adversarial network where a CT with CAC is decomposed into an image without CAC and an image showing only CAC. The method, using a CycleGAN, was trained using 626 low-dose chest CTs and 514 radiotherapy treatment planning CTs. Interscan reproducibility was compared to clinical calcium scoring in radiotherapy treatment planning CTs of 1,662 patients, each having two scans. Results: A lower relative interscan difference in CAC mass was achieved by the proposed method: 47% compared to 89% manual clinical calcium scoring. The intraclass correlation coefficient of Agatston scores was 0.96 for the proposed method compared to 0.91 for automatic clinical calcium scoring. Conclusions: The increased interscan reproducibility achieved by our method may lead to increased reliability of CHD risk categorization and improved accuracy of CHD event prediction.