European Radiology

, Volume 30, Issue 2, pp 1285–1294 | Cite as

Motion-corrected coronary calcium scores by a convolutional neural network: a robotic simulating study

  • Yaping Zhang
  • Niels R. van der Werf
  • Beibei Jiang
  • Robbert van Hamersvelt
  • Marcel J. W. Greuter
  • Xueqian XieEmail author
Imaging Informatics and Artificial Intelligence



To classify motion-induced blurred images of calcified coronary plaques so as to correct coronary calcium scores on nontriggered chest CT, using a deep convolutional neural network (CNN) trained by images of motion artifacts.


Three artificial coronary arteries containing nine calcified plaques of different densities (high, medium, and low) and sizes (large, medium, and small) were attached to a moving robotic arm. The artificial arteries moving at 0–90 mm/s were scanned to generate nine categories (each from one calcified plaque) of images with motion artifacts. An inception v3 CNN was fine-tuned and validated. Agatston scores of the predicted classification by CNN were considered as corrected scores. Variation of Agatston scores on moving plaque and by CNN correction was calculated using the scores at rest as reference.


The overall accuracy of CNN classification was 79.2 ± 6.1% for nine categories. The accuracy was 88.3 ± 4.9%, 75.9 ± 6.4%, and 73.5 ± 5.0% for the high-, medium-, and low-density plaques, respectively. Compared with the Agatston score at rest, the overall median score variation was 37.8% (1st and 3rd quartile, 10.5% and 68.8%) in moving plaques. CNN correction largely decreased the variation to 3.7% (1.9%, 9.1%) (p < 0.001, Mann–Whitney U test) and improved the sensitivity (percentage of non-zero scores among all the scores) from 65 to 85% for detection of coronary calcifications.


In this experimental study, CNN showed the ability to classify motion-induced blurred images and correct calcium scores derived from nontriggered chest CT. CNN correction largely reduces the overall Agatston score variation and increases the sensitivity to detect calcifications.

Key Points

• A deep CNN architecture trained by CT images of motion artifacts showed the ability to correct coronary calcium scores from blurred images.

• A correction algorithm based on deep CNN can be used for a tenfold reduction in Agatston score variations from 38 to 3.7% of moving coronary calcified plaques and to improve the sensitivity from 65 to 85% for the detection of calcifications.

• This experimental study provides a method to improve its accuracy for coronary calcium scores that is a fundamental step towards a real clinical scenario.


Tomography, X-ray computed Phantoms, imaging Artifacts Artificial intelligence 



Convolutional neural network


Joint Photographic Experts Group


Left anterior descending artery


Left circumflex artery


The Dutch-Belgian randomized lung cancer screening trial


Right coronary artery


Funding information

This study was sponsored by the National Natural Science Foundation of China (project no. 81471662), Ministry of Science and Technology of China (2016YFE0103000), Science and Technology Commission of Shanghai Municipality (16411968500 and 16410722300), Shanghai Municipal Education Commission – Gaofeng Clinical Medicine Grant Support (20181814), Shanghai Jiao Tong University (ZH2018ZDB10), and Clinical Research Innovation Plan of Shanghai General Hospital (CTCCR-2018B04). The funders played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Compliance with ethical standards


The scientific guarantor of this publication is Xueqian Xie, MD PhD, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Xueqian Xie, MD PhD, performed deep learning.

Informed consent

Written informed consent was not required for this study because this is not a research on human subjects.

Ethical approval

Institutional Review Board approval was not required because this is not a research on human subjects.


• Experimental

• Performed at one institution

Supplementary material

330_2019_6447_MOESM1_ESM.docx (233 kb)
ESM 1 (DOCX 232 kb)


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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  1. 1.Radiology Department, Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
  2. 2.Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
  3. 3.Department of Radiology & Nuclear MedicineErasmus University Medical CenterRotterdamThe Netherlands
  4. 4.University Medical Center Groningen, Radiology DepartmentUniversity of GroningenGroningenThe Netherlands

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