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 generating an immersive patient-specific report on cardiovascular disease state based on one or more 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, wherein the one or more arteries comprise one or more regions of plaque;   determining, by the computer system, one or more vascular parameters associated with the subject by analyzing the one or more identified arteries, 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, the one or more regions of plaque in the one or more arteries;   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;   generating, by the computer system, an assessment of cardiovascular disease state of the one or more regions of plaque based at least in part on the determined one or more plaque parameters and the one or more vascular parameters;   generating, by the computer system, a three-dimensional graphical representation of one or more plaque rupture scenarios of the one or more regions of plaque when the generated assessment of cardiovascular disease state of the one or more regions of plaque is above a pre-determined threshold level;   generating, by the computer system, a three-dimensional multiplanar reformation of the one or more arteries comprising the one or more regions of plaque based at least in part on the determined one or more vascular parameters and the one or more plaque parameters;   generating, by the computer system, an immersive three-dimensional graphical representation of the one or more arteries based at least in part on the three-dimensional multiplanar reformation of the one or more arteries, wherein the immersive three-dimensional graphical representation of the one or more arteries comprises the three-dimensional graphical representation of the one or more plaque rupture scenarios of the one or more regions of plaque when the generated assessment of cardiovascular disease state of the one or more regions of plaque is above a pre-determined threshold level; and   causing, by the computer system, transmission of the immersive three-dimensional graphical representation of the one or more arteries to a user computing device, wherein the immersive three-dimensional graphical representation of the one or more arteries is configured to allow a user to view the state of cardiovascular disease from a point of view positioned inside the one or more arteries,   wherein the computer system comprises a computer processor and an electronic storage medium.   
     
     
         2 . The computer-implemented method of  claim 1 , wherein the user computing device comprises a virtual reality (VR) device. 
     
     
         3 . The computer-implemented method of  claim 1 , wherein the pre-determined threshold level is based at least in part on density of the one or more regions of plaque. 
     
     
         4 . The computer-implemented method of  claim 1 , wherein the density of the one or more regions of plaque comprises absolute density. 
     
     
         5 . The computer-implemented method of  claim 1 , wherein the density of the one or more regions of plaque comprises radiodensity. 
     
     
         6 . The computer-implemented method of  claim 1 , wherein the immersive three-dimensional graphical representation of the one or more arteries is configured to allow a user to move the point of view within the one or more arteries in six degrees of freedom. 
     
     
         7 . The computer-implemented method of  claim 1 , wherein the immersive three-dimensional graphical representation of the one or more arteries is configured to allow a user to rotate the point of view within the one or more arteries in three degrees of freedom. 
     
     
         8 . The computer-implemented method of  claim 1 , wherein the immersive three-dimensional graphical representation of the one or more arteries is configured to allow a user to move the point of view within the one or more arteries along a longitudinal axis of the one or more arteries. 
     
     
         9 . 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 of the one or more regions of plaque. 
     
     
         10 . The computer-implemented method of  claim 9 , further comprising:
 determining, by the computer system, an expected progression of the state of cardiovascular disease of the one or more regions of plaque based on the treatment;   modifying, by the computer system, the immersive three-dimensional graphical representation of the one or more arteries based at least in part on the expected progression of the state of cardiovascular disease of the one or more regions of plaque; and   causing, by the computer system, transmission of the modified immersive three-dimensional graphical representation of the one or more arteries to the user computing device, wherein the modified immersive three-dimensional graphical representation of the one or more arteries is configured to allow the user to view the expected progression of the state of cardiovascular disease of the one or more regions of plaque from the point of view positioned within the one or more arteries.   
     
     
         11 . The computer-implemented method of  claim 9 , wherein the treatment for cardiovascular disease comprises medical intervention, medical treatment, or lifestyle change. 
     
     
         12 . The computer-implemented method of  claim 9 , further comprising tracking, by the computer system, efficacy of the treatment by determining assessment of the state of cardiovascular disease of the one or more regions of plaque at a later point in time after treatment. 
     
     
         13 . The computer-implemented method of  claim 12 , further comprising:
 modifying, by the computer system, the immersive three-dimensional graphical representation of the one or more arteries based at least in part on the assessment of the state of cardiovascular disease of the one or more regions of plaque at the later point in time after treatment of the state of cardiovascular disease; and   causing, by the computer system, transmission of the modified immersive three-dimensional graphical representation of the one or more arteries to the user computing device, wherein the modified immersive three-dimensional graphical representation of the one or more arteries is configured to allow the user to view a change in the state of cardiovascular disease of the one or more regions of plaque after treatment from the point of view positioned within the one or more arteries.   
     
     
         14 . The computer-implemented method of  claim 1 , wherein the state of assessment of cardiovascular disease state of the one or more regions of plaque based at least in part on a weighted measure of the one or more plaque parameters and the one or more vascular 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 and the one or more plaque parameters,   wherein the assessment of the state of cardiovascular disease of the one or more regions of plaque is further determined based at least in part on the generated weighted measure.   
     
     
         16 . The computer-implemented method of  claim 1 , wherein the assessment of the state of cardiovascular disease of the one or more regions of plaque is further determined based at least in part on one or more of age or gender of the subject. 
     
     
         17 . 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), 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). 
     
     
         18 . A system for generating an immersive patient-specific report on cardiovascular disease state based on one or more 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, wherein the one or more arteries comprise one or more regions of plaque; 
 determine one or more vascular parameters associated with the subject by analyzing the one or more identified arteries, 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 the one or more regions of plaque in the one or more arteries; 
 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; 
 generate an assessment of cardiovascular disease state of the one or more regions of plaque based at least in part on the determined one or more plaque parameters and one or more vascular parameters; 
 generate a three-dimensional graphical representation of one or more plaque rupture scenarios of the one or more regions of plaque when the generated assessment of cardiovascular disease state of the one or more regions of plaque is above a pre-determined threshold level; 
 generate a three-dimensional multiplanar reformation of the one or more arteries comprising the one or more regions of plaque based at least in part on the determined one or more vascular parameters and the one or more plaque parameters; 
 generate an immersive three-dimensional graphical representation of the one or more arteries based at least in part on the three-dimensional multiplanar reformation of the one or more arteries, wherein the immersive three-dimensional graphical representation of the one or more arteries comprises the three-dimensional graphical representation of the one or more plaque rupture scenarios of the one or more regions of plaque when the generated assessment of cardiovascular disease state of the one or more regions of plaque is above a pre-determined threshold level; and 
 cause transmission of the immersive three-dimensional graphical representation of the one or more arteries to a user computing device, wherein the immersive three-dimensional graphical representation of the one or more arteries is configured to allow a user to view the state of cardiovascular disease from a point of view positioned inside the one or more arteries. 
   
     
     
         19 . The system of  claim 18 , wherein the user computing device comprises a virtual reality (VR) device. 
     
     
         20 . The system of  claim 18 , wherein the pre-determined threshold level is based at least in part on density of the one or more regions of plaque. 
     
     
         21 . The system of  claim 18 , wherein the density of the one or more regions of plaque comprises absolute density. 
     
     
         22 . The system of  claim 18 , wherein the density of the one or more regions of plaque comprises radiodensity. 
     
     
         23 . The system of  claim 18 , wherein the immersive three-dimensional graphical representation of the one or more arteries is configured to allow a user to move the point of view within the one or more arteries in six degrees of freedom. 
     
     
         24 . The system of  claim 18 , wherein the immersive three-dimensional graphical representation of the one or more arteries is configured to allow a user to rotate the point of view within the one or more arteries in three degrees of freedom. 
     
     
         25 . The system of  claim 18 , wherein the immersive three-dimensional graphical representation of the one or more arteries is configured to allow a user to move the point of view within the one or more arteries along a longitudinal axis of the one or more arteries. 
     
     
         26 . The system of  claim 18 , 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 of the one or more regions of plaque. 
     
     
         27 . The system of  claim 26 , wherein the system is further caused to:
 determine an expected progression of the state of cardiovascular disease of the one or more regions of plaque based on the treatment;   modify the immersive three-dimensional graphical representation of the one or more arteries based at least in part on the expected progression of the state of cardiovascular disease of the one or more regions of plaque; and   cause transmission of the modified immersive three-dimensional graphical representation of the one or more arteries to the user computing device, wherein the modified immersive three-dimensional graphical representation of the one or more arteries is configured to allow the user to view the expected progression of the state of cardiovascular disease of the one or more regions of plaque from the point of view positioned within the one or more arteries.   
     
     
         28 . The system of  claim 26 , wherein the treatment for cardiovascular disease comprises medical intervention, medical treatment, or lifestyle change. 
     
     
         29 . The system of  claim 26 , wherein the system is further caused to track efficacy of the treatment by determining assessment of the state of cardiovascular disease of the one or more regions of plaque at a later point in time after treatment. 
     
     
         30 . The system of  claim 29 , wherein the system is further caused to:
 modify the immersive three-dimensional graphical representation of the one or more arteries based at least in part on the assessment of the state of cardiovascular disease of the one or more regions of plaque at the later point in time after treatment of the state of cardiovascular disease; and   cause transmission of the modified immersive three-dimensional graphical representation of the one or more arteries to the user computing device, wherein the modified immersive three-dimensional graphical representation of the one or more arteries is configured to allow the user to view a change in the state of cardiovascular disease of the one or more regions of plaque after treatment from the point of view positioned within the one or more arteries.   
     
     
         31 . The system of  claim 18 , wherein the state of assessment of cardiovascular disease state of the one or more regions of plaque based at least in part on a weighted measure of the one or more plaque parameters and the one or more vascular parameters. 
     
     
         32 . The system of  claim 18 , wherein the system is further caused to:
 generate a weighted measure of one or more of the one or more vascular parameters and the one or more plaque parameters,   wherein the assessment of the state of cardiovascular disease of the one or more regions of plaque is further determined based at least in part on the generated weighted measure.   
     
     
         33 . The system of  claim 18 , wherein the assessment of the state of cardiovascular disease of the one or more regions of plaque is further determined based at least in part on one or more of age or gender of the subject. 
     
     
         34 . The system of  claim 18 , 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), 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).