# Clinical Risk-Aware Multi-Level Grading for Coronary Artery Stenosis through Curved Feature Reconstruction

arXiv: https://arxiv.org/abs/2606.30082 · HTML: https://mlsanity.com/paper/2606.30082/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 11 of its 30 references that are in the map.
- First posted on arXiv 29 Jun 2026.

## Builds on (most cited first, 11 of 11)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [A Recurrent CNN for Automatic Detection and Classification of Coronary Artery Plaque and Stenosis in Coronary CT Angiography](https://mlsanity.com/paper/1804.04360/) (2018)
- [Transformer Network for Significant Stenosis Detection in CCTA of Coronary Arteries](https://mlsanity.com/paper/2107.03035/) (2021)
- [Cost-Sensitive Regularization for Diabetic Retinopathy Grading from Eye Fundus Images](https://mlsanity.com/paper/2010.00291/) (2020)
- [PointScatter: Point Set Representation for Tubular Structure Extraction](https://mlsanity.com/paper/2209.05774/) (2022)
- [Coronary Artery Plaque Characterization from CCTA Scans using Deep Learning and Radiomics](https://mlsanity.com/paper/1912.06075/) (2019)
- [DeformCL: Learning Deformable Centerline Representation for Vessel Extraction in 3D Medical Image](https://mlsanity.com/paper/2506.05820/) (2025)
- [Topology-Preserving Automatic Labeling of Coronary Arteries via Anatomy-aware Connection Classifier](https://mlsanity.com/paper/2307.11959/) (2023)

## Abstract (arXiv)

Developing a multi-level grading model for coronary artery stenosis holds great clinical significance for the diagnosis of coronary artery disease. However, designing an effective multi-level deep learning algorithm faces significant challenges. Specifically, utilizing CCTA or 3D SCPR images alone presents inherent shortcomings: CCTA images are difficult to analyze due to the tortuous paths of blood vessels, while 3D SCPR images are prone to abnormal distortions that hinder accurate grading. Furthermore, different stenosis grades are associated with varying clinical risks, and incorporating this association into the algorithm is non-trivial. To address the former problems, we propose the Curved Feature Reconstruction (CFR) module, which uses vessel curves as prior and employs a point-by-point correspondence strategy to precisely align and fuse features from both 3D SCPR and CCTA images. Meanwhile, a Clinical Risk-Aware (CR) Loss is employed to introduce clinical risk relevance into the network training so that the algorithm can better align with the clinical diagnosis. The experimental results on a in-house dataset reveal that our approach significantly outperforms other methods, and several ablation studies also demonstrate the effectiveness of our proposed designs.