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Artificial intelligence approaches to predict coronary stenosis severity using non-invasive fractional flow reserve

Jason M. Carson Orcid Logo, Neeraj Kavan Chakshu, Igor Sazonov Orcid Logo, Perumal Nithiarasu Orcid Logo

Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, Volume: 234, Issue: 11, Pages: 1337 - 1350

Swansea University Authors: Jason M. Carson Orcid Logo, Neeraj Kavan Chakshu, Igor Sazonov Orcid Logo, Perumal Nithiarasu Orcid Logo

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Abstract

Fractional flow reserve is the current reference standard in the assessment of the functional impact of a stenosis in coronary heart disease. In this study, three models of artificial intelligence of varying degrees of complexity were compared to fractional flow reserve measurements. The three model...

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Published in: Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine
ISSN: 0954-4119 2041-3033
Published: SAGE Publications 2020
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa54883
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Abstract: Fractional flow reserve is the current reference standard in the assessment of the functional impact of a stenosis in coronary heart disease. In this study, three models of artificial intelligence of varying degrees of complexity were compared to fractional flow reserve measurements. The three models are the multivariate polynomial regression, which is a statistical method used primarily for correlation; the feed-forward neural network; and the long short-term memory, which is a type of recurrent neural network that is suited to modelling sequences. The models were initially trained using a virtual patient database that was generated from a validated one-dimensional physics-based model. The feed-forward neural network performed the best for all test cases considered, which were a single vessel case from a virtual patient database, a multi-vessel network from a virtual patient database, and 25 clinically invasive fractional flow reserve measurements from real patients. The feed-forward neural network model achieved around 99% diagnostic accuracy in both tests involving virtual patients, and a respectable 72% diagnostic accuracy when compared to the invasive fractional flow reserve measurements. The multivariate polynomial regression model performed well in the single vessel case, but struggled on network cases as the variation of input features was much larger. The long short-term memory performed well for the single vessel cases, but tended to have a bias towards a positive fractional flow reserve prediction for the virtual multi-vessel case, and for the patient cases. Overall, the feed-forward neural network shows promise in successfully predicting fractional flow reserve in real patients, and could be a viable option if trained using a large enough data set of real patients.
Keywords: Artificial intelligence, computational mechanics, biomedical engineering, haemodynamic modelling, coronary heart disease, fractional flow reserve
College: Faculty of Science and Engineering
Issue: 11
Start Page: 1337
End Page: 1350