A Domain Enriched Deep Learning Approach to Classify Atherosclerosis Using Intravascular Ultrasound Imaging

Intravascular ultrasound (IVUS) imaging is widely used for diagnostic imaging in interventional cardiology. The detection and quantification of atherosclerosis from acquired images is typically performed manually by medical experts or by virtual histology IVUS (VH-IVUS) software. VH-IVUS analyzes backscattered radio frequency (RF) signals to provide a color-coded tissue map, and is the method of choice for assessing atherosclerotic plaque in situ. However, a significant amount of tissue cannot be analyzed in reasonable time because the method can be applied just once per cardiac cycle. Furthermore, only hardware and software compatible with RF signal acquisition and processing may be used. In this article, we present an image-based tissue characterization method that can be applied to entire acquisition sequences post hoc for the assessment of diseased vessels. The pixel-based method utilizes domain knowledge of arterial pathology and physiology, and leverages technological advances of convolutional neural networks to segment diseased vessel walls into the same tissue classes as virtual histology using only grayscale IVUS images. The method was trained and tested on patches extracted from VH-IVUS images acquired from several patients, and achieved overall accuracy of 93.5% for all segmented tissue. Imposing physically-relevant spatial constraints driven by domain knowledge was key to achieving such strong performance. This enriched approach offers capabilities akin to VH-IVUS without the constraints of RF signals or limited once-per-cycle analysis, offering superior potential information acquisition speed, reduced hardware and software requirements, and more widespread applicability. Such an approach may well yield promise for future clinical and research applications.