  Coronary artery calcium (CAC) is a significant marker of atherosclerosis and
cardiovascular events. In this work we present a system for the automatic
quantification of calcium score in ECG-triggered non-contrast enhanced cardiac
computed tomography (CT) images. The proposed system uses a supervised deep
learning algorithm, i.e. convolutional neural network (CNN) for the
segmentation and classification of candidate lesions as coronary or not,
previously extracted in the region of the heart using a cardiac atlas. We
trained our network with 45 CT volumes; 18 volumes were used to validate the
model and 56 to test it. Individual lesions were detected with a sensitivity of
91.24%, a specificity of 95.37% and a positive predicted value (PPV) of 90.5%;
comparing calcium score obtained by the system and calcium score manually
evaluated by an expert operator, a Pearson coefficient of 0.983 was obtained. A
high agreement (Cohen's k = 0.879) between manual and automatic risk prediction
was also observed. These results demonstrated that convolutional neural
networks can be effectively applied for the automatic segmentation and
classification of coronary calcifications.
