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Background: The curved planar reformation (CPR) technique is one of the most commonly used methods in clinical practice to locate coronary arteries in medical images. Purpose: The artery centerline is the cornerstone for the generation of the CPR image. Here, we describe the development of a new fully automatic artery centerline tracker with the aim of increasing the efficiency and accuracy of the process. Methods: We propose a COronary artery Centerline Tracker (COACT) framework which consists of an ostium point finder (OPFinder) model, an intersection point detector (IPDetector) model and a set of centerline tracking strategies. The output of OPFinder is the ostium points. The function of the IPDetector is to predict the intersections of a sample sphere and the centerlines. The centerline tracking process starts from two ostium points detected by the OPFinder, and combines the results of the IPDetector with a series of strategies to gradually reconstruct the coronary artery centerline tree. Results: Two coronary CT angiography (CCTA) datasets were used to validate the models. Dataset1 contains 160 cases (32 for test and 128 for training) and dataset2 contains 70 cases (20 for test and 50 for training). The results show that the average distance between the ostium points predicted by the OPFinder and the manually annotated ostium points was 0.88 mm, which is similar to the differences between the results obtained by two observers (0.85 mm). For the IPDetector, the average overlap of the predicted and ground truth intersection points was 97.82% and this is also close to the inter‐observer agreement of 98.50%. For the entire coronary centerline tree, the overlap between the results obtained by COACT and the gold standard was 94.33%, which is slightly lower than the inter‐observer agreement, 98.39%. Conclusions: We have developed a fully automatic centerline tracking method for CCTA scans and achieved a satisfactory result. The proposed algorithms are also incorporated in the medical image analysis platform TIMESlice (https://slice‐doc.netlify.app) for further studies. [ABSTRACT FROM AUTHOR]

To compare the prediction performance of the epicardial adipose tissue (EAT) and pericoronary adipose tissue (PCAT) radiomics models based on coronary computed tomography angiography for major adverse cardiovascular events (MACE) within 3 years. Our study included 288 patients (144 with MACE and 144 without MACE within 3 years) by matching age, gender, body mass index, and medication intake. Patients were randomly assigned either to the training (n = 201) or validation cohort (n = 87). A total of 184 radiomics features were extracted from EAT and PCAT images. Spearman's rank correlation coefficient and the gradient boosting decision tree algorithm were performed for feature selection. Five models were established based on PCAT or EAT radiomics features and clinical factors, including PCAT, EAT, clinical, PCAT-clinical, and EAT-clinical model (M PCAT , M EAT , M clinical , M PCAT-clinical , and M EAT-clinical). Receiver operating characteristic curves, calibration curves, and the decision curve analysis were plotted to evaluate the model performance. The M PCAT achieved an area under the curve (AUC) of 0.703 in the validation cohort, which was better than M EAT with AUC of 0.538. The M PCAT-clinical showed better performance (AUC = 0.781) in predicting MACE than the M clinical (AUC = 0.748) or M EAT-clinical (AUC = 0.745). Our results showed that the PCAT was better than the EAT in both single modality and combined models, and the M PCAT-clinical had the most significant clinical value in predicting the occurrence of MACE within 3 years. [ABSTRACT FROM AUTHOR]