Topological Image Analysis of Coronary Calcifications for Improved Cardiovascular Risk Prediction from Screening Non-Contrast CT

Prerna Singh, Ammar Hoori, Sadeer Al-Kindi, Sanjay Rajagopalan, David L. Wilson

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Accurately identifying high-risk cardiovascular patients is crucial to prevent myocardial infarctions and revascularizations. However, traditional risk assessments, such as the Agatston score, quantify coronary artery calcifications (CAC) at ≥130 Hounsfield units (HU), overlooking the contribution of lower-density calcifications. We introduce TopologyCAC, a model that leverages topological image analysis and persistent homology to capture the structure, spatial distribution, and persistence of CACs across lowered HU thresholds in CT calcium score (CTCS) images. In a cohort of 2,132 patients, TopologyCAC outperformed the Agatston score, achieving a testing Net Reclassification Improvement (NRI) of 0.11 on the testing set. Additionally, for patients under 60 years, TopologyCAC achieved a testing C-index of 0.81 in this preliminary analysis, significantly improving early-stage disease risk stratification.

Original languageEnglish (US)
Title of host publicationISBI 2025 - 2025 IEEE 22nd International Symposium on Biomedical Imaging, Proceedings
PublisherInstitute of Electrical and Electronics Engineers Inc.
ISBN (Electronic)9798331520526
DOIs
StatePublished - 2025
Event22nd IEEE International Symposium on Biomedical Imaging, ISBI 2025 - Houston, United States
Duration: Apr 14 2025Apr 17 2025

Publication series

NameProceedings - International Symposium on Biomedical Imaging
ISSN (Print)1945-7928
ISSN (Electronic)1945-8452

Conference

Conference22nd IEEE International Symposium on Biomedical Imaging, ISBI 2025
Country/TerritoryUnited States
CityHouston
Period4/14/254/17/25

Keywords

  • atherosclerosis
  • CT calcium score
  • risk prediction
  • Topological image analysis

ASJC Scopus subject areas

  • Biomedical Engineering
  • Radiology Nuclear Medicine and imaging

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