Systems, devices, and methods for non-invasive image-based plaque analysis and risk determination

Abstract

Systems and methods of facilitating determination of risk of coronary artery disease (CAD) based at least in part on one or more measurements derived from non-invasive medical image analysis. The methods can include accessing a non-invasive generated medical image, identifying one or more arteries, identifying, regions of plaque within an artery, analyzing the regions of plaque to identify low density non-calcified plaque, non-calcified plaque, or calcified plaque based at least in part on density, determining a distance from identified regions of low density non-calcified plaque to one or more of a lumen wall or vessel wall, determining embeddedness of the regions of low density non-calcified plaque by one or more of non-calcified plaque or calcified plaque, determining a shape of the more regions of low density non-calcified plaque, and generating a display of the analysis to facilitate determination of one or more of a risk of CAD of the subject.

1 . A computer-implemented method of assessing a state of cardiovascular disease of a subject based on one or more normalized relational plaque parameters derived from non-invasive medical image analysis, the method comprising:
 accessing, by a computer system, a medical image of a subject, wherein the medical image of the subject is obtained non-invasively;   analyzing, by the computer system, the medical image of the subject to identify one or more arteries;   applying, by the computer system, a vessel threshold to the one or more arteries identified from the medical image to determine one or more arterial sections of interest above the vessel threshold;   determining, by the computer system, one or more vascular parameters associated with the subject by analyzing the one or more arterial sections of interest, wherein the one or more vascular parameters comprise one or more of vessel volume, diameter, area, cross-sectional area, surface area, length, location, or remodeling;   identifying, by the computer system, one or more regions of plaque in the arterial sections of interest;   determining, by the computer system, one or more plaque parameters associated with the one or more regions of plaque, wherein the one or more plaque parameters comprise one or more of plaque density, composition, calcification, radiodensity, location, volume, surface area, geometry, heterogeneity, diffusivity, or ratio between volume and surface area;   determining, by the computer system, one or more relational plaque parameters for the subject, the one or more relational plaque parameters determined by comparing the one or more plaque parameters to the one or more vascular parameters;   normalizing, by the computer system, the one or more relational plaque parameters for the subject by comparison to one or more physical properties of the subject;   analyzing, by the computer system, the normalized one or more relational plaque parameters for the subject by comparison to a dataset of values, the values comprising a plurality of normalized one or more relational plaque parameters derived from applying the vessel threshold to a plurality of medical images of a population with varying states of cardiovascular disease; and   determining, by the computer system, an assessment of a state of cardiovascular disease of the subject based at least in part on analysis of the normalized one or more relational plaque parameters for the subject,   wherein the computer system comprises a computer processor and an electronic storage medium.   
     
     
         2 . The computer-implemented method of  claim 1 , wherein the vessel threshold comprises about 2.0 mm in diameter. 
     
     
         3 . The computer-implemented method of  claim 1 , wherein the one or more relational plaque parameters comprises percent atheroma volume (PAV). 
     
     
         4 . The computer-implemented method of  claim 3 , wherein the PAV comprises total plaque volume over vessel volume of the one or more arterial sections of interest. 
     
     
         5 . The computer-implemented method of  claim 3 , wherein the PAV comprises non-calcified plaque volume over vessel volume of the one or more arterial sections of interest. 
     
     
         6 . The computer-implemented method of  claim 3 , wherein the PAV comprises low-density non-calcified plaque volume over vessel volume of the one or more arterial sections of interest. 
     
     
         7 . The computer-implemented method of  claim 1 , wherein the vessel threshold comprises about 2.0 mm in diameter, and wherein the one or more relational plaque parameters comprises percent atheroma volume (PAV). 
     
     
         8 . The computer-implemented method of  claim 1 , wherein the one or more physical properties of the subject comprises body mass of the subject. 
     
     
         9 . The computer-implemented method of  claim 1 , wherein the one or more physical properties of the subject comprises left ventricular mass of the subject. 
     
     
         10 . The computer-implemented method of  claim 9 , wherein the left ventricular mass of the subject is determined based at least in part on the medical image of the subject. 
     
     
         11 . The computer-implemented method of  claim 1 , wherein the medical image is obtained using an imaging technique comprising one or more of computed tomography (CT), x-ray, ultrasound, echocardiography, intravascular ultrasound (IVUS), magnetic resonance (MR) imaging, optical coherence tomography (OCT), nuclear medicine imaging, positron-emission tomography (PET), single photon emission computed tomography (SPECT), or near-field infrared spectroscopy (NIRS). 
     
     
         12 . The computer-implemented method of  claim 1 , wherein the vessel threshold varies by vessel. 
     
     
         13 . The computer-implemented method of  claim 1 , wherein the vessel threshold is determined based at least in part on quality of the medical image. 
     
     
         14 . The computer-implemented method of  claim 1 , wherein the assessment of the state of cardiovascular disease of the subject is further determined based at least in part on the one or more vascular parameters or the one or more plaque parameters. 
     
     
         15 . The computer-implemented method of  claim 1 , further comprising:
 generating, by the computer system, a weighted measure of one or more of the one or more vascular parameters, one or more plaque parameters, or one or more relational plaque parameters,   wherein the assessment of the state of cardiovascular disease of the subject is further determined based at least in part on the generated weighted measure.   
     
     
         16 . The computer-implemented method of  claim 1 , further comprising generating, by the computer system, a treatment for cardiovascular disease for the subject based at least in part on the determined assessment of the state of cardiovascular disease. 
     
     
         17 . The computer-implemented method of  claim 16 , wherein the treatment for cardiovascular disease comprises medical intervention, medical treatment, or lifestyle change. 
     
     
         18 . The computer-implemented method of  claim 16 , further comprising tracking, by the computer system, efficacy of the treatment by determining assessment of the state of cardiovascular disease of the subject at a later point in time after treatment. 
     
     
         19 . A system for assessing a state of cardiovascular disease of a subject based on one or more normalized relational plaque parameters derived from non-invasive medical image analysis, the system comprising:
 one or more computer readable storage devices configured to store a plurality of computer executable instructions; and   one or more hardware computer processors in communication with the one or more computer readable storage devices and configured to execute the plurality of computer executable instructions in order to cause the system to:
 access a medical image of a subject, wherein the medical image of the subject is obtained non-invasively; 
 analyze the medical image of the subject to identify one or more arteries; 
 apply a vessel threshold to the one or more arteries identified from the medical image to determine one or more arterial sections of interest above the vessel threshold; 
 determine one or more vascular parameters associated with the subject by analyzing the one or more arterial sections of interest, wherein the one or more vascular parameters comprise one or more of vessel volume, diameter, area, cross-sectional area, surface area, length, location, or remodeling; 
 identify one or more regions of plaque in the arterial sections of interest; 
 determine one or more plaque parameters associated with the one or more regions of plaque, wherein the one or more plaque parameters comprise one or more of plaque density, composition, calcification, radiodensity, location, volume, surface area, geometry, heterogeneity, diffusivity, or ratio between volume and surface area; 
 determine one or more relational plaque parameters for the subject, the one or more relational plaque parameters determined by comparing the one or more plaque parameters to the one or more vascular parameters; 
 normalize the one or more relational plaque parameters for the subject by comparison to one or more physical properties of the subject; 
 analyze the normalized one or more relational plaque parameters for the subject by comparison to a dataset of values, the values comprising a plurality of normalized one or more relational plaque parameters derived from applying the vessel threshold to a plurality of medical images of a population with varying states of cardiovascular disease; and 
 determine an assessment of a state of cardiovascular disease of the subject based at least in part on analysis of the normalized one or more relational plaque parameters for the subject. 
   
     
     
         20 . The system of  claim 19 , wherein the vessel threshold comprises about 2.0 mm in diameter. 
     
     
         21 . The system of  claim 19 , wherein the one or more relational plaque parameters comprises percent atheroma volume (PAV). 
     
     
         22 . The system of  claim 22 , wherein the PAV comprises total plaque volume over vessel volume of the one or more arterial sections of interest. 
     
     
         23 . The system of  claim 22 , wherein the PAV comprises non-calcified plaque volume over vessel volume of the one or more arterial sections of interest. 
     
     
         24 . The system of  claim 22 , wherein the PAV comprises low-density non-calcified plaque volume over vessel volume of the one or more arterial sections of interest. 
     
     
         25 . The system of  claim 19 , wherein the vessel threshold comprises about 2.0 mm in diameter, and wherein the one or more relational plaque parameters comprises percent atheroma volume (PAV). 
     
     
         26 . The system of  claim 19 , wherein the one or more physical properties of the subject comprises body mass of the subject. 
     
     
         27 . The system of  claim 19 , wherein the one or more physical properties of the subject comprises left ventricular mass of the subject. 
     
     
         28 . The system of  claim 27 , wherein the left ventricular mass of the subject is determined based at least in part on the medical image of the subject. 
     
     
         29 . The system of  claim 19 , wherein the medical image is obtained using an imaging technique comprising one or more of computed tomography (CT), x-ray, ultrasound, echocardiography, intravascular ultrasound (IVUS), magnetic resonance (MR) imaging, optical coherence tomography (OCT), nuclear medicine imaging, positron-emission tomography (PET), single photon emission computed tomography (SPECT), or near-field infrared spectroscopy (NIRS). 
     
     
         30 . The system of  claim 19 , wherein the vessel threshold varies by vessel. 
     
     
         31 . The system of  claim 19 , wherein the vessel threshold is determined based at least in part on quality of the medical image. 
     
     
         32 . The system of  claim 19 , wherein the assessment of the state of cardiovascular disease of the subject is further determined based at least in part on the one or more vascular parameters or the one or more plaque parameters. 
     
     
         33 . The system of  claim 19 , wherein the system is further caused to:
 generate a weighted measure of one or more of the one or more vascular parameters, one or more plaque parameters, or one or more relational plaque parameters,   wherein the assessment of the state of cardiovascular disease of the subject is further determined based at least in part on the generated weighted measure.   
     
     
         34 . The system of  claim 19 , wherein the system is further caused to generate a treatment for cardiovascular disease for the subject based at least in part on the determined assessment of the state of cardiovascular disease. 
     
     
         35 . The system of  claim 34 , wherein the treatment for cardiovascular disease comprises medical intervention, medical treatment, or lifestyle change. 
     
     
         36 . The system of  claim 34 , wherein the system is further caused to track efficacy of the treatment by determining assessment of the state of cardiovascular disease of the subject at a later point in time after treatment.