TY - JOUR

T1 - Effect of high-intensity statin therapy on atherosclerosis (IBIS-4)

T2 - Manual versus automated methods of IVUS analysis

AU - Bass, Ronald D.

AU - García-García, Héctor M.

AU - Ueki, Yasushi

AU - Holmvang, Lene

AU - Pedrazzini, Giovanni

AU - Roffi, Marco

AU - Koskinas, Konstantinos C.

AU - Shibutani, Hiroki

AU - Losdat, Sylvain

AU - Ziemer, Paulo G.P.

AU - Blanco, Pablo J.

AU - Levine, Molly B.

AU - Bourantas, Christos V.

AU - Räber, Lorenz

N1 - Publisher Copyright: © 2023

PY - 2023

Y1 - 2023

N2 - Aims: Standard manual analysis of IVUS to study the impact of anti-atherosclerotic therapies on the coronary vessel wall is done by a core laboratory (CL), the ground truth (GT). Automatic segmentation of IVUS with a machine learning (ML) algorithm has the potential to replace manual readings with an unbiased and reproducible method. The aim is to determine if results from a CL can be replicated with ML methods. Methods: This is a post-hoc, comparative analysis of the IBIS-4 (Integrated Biomarkers and Imaging Study-4) study (NCT00962416). The GT baseline and 13-month follow-up measurements of lumen and vessel area and percent atheroma volume (PAV) after statin induction were repeated by the ML algorithm. Results: The primary endpoint was change in PAV. PAV as measured by GT was 43.95 % at baseline and 43.02 % at follow-up with a change of −0.90 % (p = 0.007) while the ML algorithm measured 43.69 % and 42.41 % for baseline and follow-up, respectively, with a change of −1.28 % (p < 0.001). Along the most diseased 10 mm segments, GT-PAV was 52.31 % at baseline and 49.42 % at follow-up, with a change of −2.94 % (p < 0.001). The same segments measured by the ML algorithm resulted in PAV of 51.55 % at baseline and 47.81 % at follow-up with a change of −3.74 % (p < 0.001). Conclusions: PAV, the most used endpoint in clinical trials, analyzed by the CL is closely replicated by the ML algorithm. ML automatic segmentation of lumen, vessel and plaque effectively reproduces GT and may be used in future clinical trials as the standard.

AB - Aims: Standard manual analysis of IVUS to study the impact of anti-atherosclerotic therapies on the coronary vessel wall is done by a core laboratory (CL), the ground truth (GT). Automatic segmentation of IVUS with a machine learning (ML) algorithm has the potential to replace manual readings with an unbiased and reproducible method. The aim is to determine if results from a CL can be replicated with ML methods. Methods: This is a post-hoc, comparative analysis of the IBIS-4 (Integrated Biomarkers and Imaging Study-4) study (NCT00962416). The GT baseline and 13-month follow-up measurements of lumen and vessel area and percent atheroma volume (PAV) after statin induction were repeated by the ML algorithm. Results: The primary endpoint was change in PAV. PAV as measured by GT was 43.95 % at baseline and 43.02 % at follow-up with a change of −0.90 % (p = 0.007) while the ML algorithm measured 43.69 % and 42.41 % for baseline and follow-up, respectively, with a change of −1.28 % (p < 0.001). Along the most diseased 10 mm segments, GT-PAV was 52.31 % at baseline and 49.42 % at follow-up, with a change of −2.94 % (p < 0.001). The same segments measured by the ML algorithm resulted in PAV of 51.55 % at baseline and 47.81 % at follow-up with a change of −3.74 % (p < 0.001). Conclusions: PAV, the most used endpoint in clinical trials, analyzed by the CL is closely replicated by the ML algorithm. ML automatic segmentation of lumen, vessel and plaque effectively reproduces GT and may be used in future clinical trials as the standard.

KW - Coronary artery disease

KW - Intravascular ultrasound

KW - Lumen segmentation

KW - Machine learning

KW - Vessel segmentation

U2 - 10.1016/j.carrev.2023.04.007

DO - 10.1016/j.carrev.2023.04.007

M3 - Journal article

C2 - 37087308

AN - SCOPUS:85152935718

VL - 54

SP - 33

EP - 38

JO - Cardiovascular Revascularization Medicine

JF - Cardiovascular Revascularization Medicine

SN - 1553-8389

ER -