Clinical Risk-Aware Multi-Level Grading for Coronary Artery Stenosis through Curved Feature Reconstruction
This study addresses the challenges in existing methods for multi-class coronary artery stenosis grading using fused CCTA and 3D SCPR images, which suffer from inaccurate alignment and neglect of clinically relevant risk differences across stenosis severity levels. To overcome these limitations, the authors propose a Curved Feature Reconstruction (CFR) module that leverages geometric priors of vessel centerlines to achieve point-wise alignment and feature fusion between the two modalities. Additionally, a Clinical Risk-aware (CR) loss function is introduced to explicitly embed differential clinical risks into the training process. Integrated within a deep multi-class classification network, the proposed approach significantly outperforms current methods on an internal dataset. Ablation studies confirm the effectiveness of both the CFR module and the CR loss, demonstrating improved alignment with clinical requirements in stenosis grading.