Original Article

Facilitating Timely Decision-Making in Healthcare: an Object Detection Approach for Automated Coronary Artery Stenosis Detection

Abstract

Purpose: Coronary Artery Disease (CAD), characterized by coronary artery stenosis—the narrowing of arteries supplying blood to the heart—is a leading global cause of morbidity and mortality. Timely detection and management of stenosis are crucial to preventing severe outcomes such as myocardial infarction and heart failure. Despite advancements in medical imaging, current diagnostic methods rely heavily on the manual interpretation of coronary angiograms, which is time-consuming, subjective, and prone to variability. To address these limitations, this study proposes an automated object detection-based framework for identifying coronary artery stenosis in medical imaging.

Materials and Methods: The study employs two state-of-the-art deep learning models, RetinaNet and EfficientDet D3, to detect stenotic regions in X-ray angiography images. A dataset of 8,325 annotated images from 100 patients with single-vessel CAD, sourced from the Research Institute for Complex Issues of Cardiovascular Diseases in Kemerovo, Russia, was used for training and evaluation. To enhance model performance, a comprehensive preprocessing pipeline was applied, including image resizing, data augmentation, and intensity normalization. These steps ensured robustness and generalizability across diverse imaging conditions.

Results: Both models demonstrated high accuracy in stenosis detection. RetinaNet achieved a mean Average Precision (mAP) of 93.2%, while EfficientDet D3 outperformed with an mAP of 96.6%. These results highlight the models' ability to accurately identify stenosis, even in noisy and variable angiographic images. The superior performance of EfficientDet D3 underscores its potential for clinical integration, offering precise and reliable stenosis localization.

Conclusion: This study presents a robust and efficient deep learning framework for the automated detection of coronary artery stenosis. By reducing reliance on manual interpretation and enhancing diagnostic accuracy, the proposed approach supports timely and informed clinical decision-making. This innovation has the potential to streamline diagnostic workflows, improve patient outcomes, and advance the application of artificial intelligence in cardiovascular healthcare.

1- Haidong Wang et al., "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015." The lancet, Vol. 388 (No. 10053), pp. 1459-544, (2016).
2- Mojdeh Nazari, Hassan Emami, Reza Rabiei, Azamossadat Hosseini, and Shahabedin Rahmatizadeh, "Detection of Cardiovascular Diseases Using Data Mining Approaches: Application of an Ensemble-Based Model." Cognitive Computation, pp. 1-15, (2024).
3- JG Myers, JA Moore, M Ojha, KW Johnston, and CR Ethier, "Factors influencing blood flow patterns in the human right coronary artery." Annals of biomedical engineering, Vol. 29pp. 109-20, (2001).
4- Erling Falk, "Pathogenesis of atherosclerosis." Journal of the American College of cardiology, Vol. 47 (No. 8S), pp. C7-C12, (2006).
5- Hossein Sadr, Arsalan Salari, Mohammad Taghi Ashoobi, and Mojdeh Nazari, "Cardiovascular disease diagnosis: a holistic approach using the integration of machine learning and deep learning models." European Journal of Medical Research, Vol. 29 (No. 1), p. 455, (2024).
6- Zahra Alkan Saberi, Hossein Sadr, and Mohammad Reza Yamaghani, "An Intelligent Diagnosis System for Predicting Coronary Heart Disease." in 2024 10th International Conference on Artificial Intelligence and Robotics (QICAR), (2024): IEEE, pp. 131-37.
7- Patrick Kierkegaard, "Electronic health record: Wiring Europe’s healthcare." Computer law & security review, Vol. 27 (No. 5), pp. 503-15, (2011).
8- Amanda H Gonsalves, Fadi Thabtah, Rami Mustafa A Mohammad, and Gurpreet Singh, "Prediction of coronary heart disease using machine learning: an experimental analysis." in Proceedings of the 2019 3rd International Conference on Deep Learning Technologies, (2019), pp. 51-56.
9- Zeinab Khodaverdian, Hossein Sadr, and Seyed Ahmad Edalatpanah, "A shallow deep neural network for selection of migration candidate virtual machines to reduce energy consumption." in 2021 7th International conference on web research (ICWR), (2021): IEEE, pp. 191-96.
10- Mojdeh Nazari, Shadi Moayed Rezaie, Fereshteh Yaseri, Hossein Sadr, and Elham Nazari, "Design and analysis of a telemonitoring system for high-risk pregnant women in need of special care or attention." BMC Pregnancy and Childbirth, Vol. 24 (No. 1), p. 817, 2024/12/18 (2024).
11- Emmanuel Ovalle-Magallanes, Juan Gabriel Avina-Cervantes, Ivan Cruz-Aceves, and Jose Ruiz-Pinales, "Hybrid classical–quantum Convolutional Neural Network for stenosis detection in X-ray coronary angiography." Expert Systems with Applications, Vol. 189p. 116112, (2022).
12- Shirin Dehghan, Reza Rabiei, Hamid Choobineh, Keivan Maghooli, Mozhdeh Nazari, and Mojtaba Vahidi-Asl, "Comparative study of machine learning approaches integrated with genetic algorithm for IVF success prediction." Plos one, Vol. 19 (No. 10), p. e0310829, (2024).
13- Emmanuel Ovalle-Magallanes, Dora E Alvarado-Carrillo, Juan Gabriel Avina-Cervantes, Ivan Cruz-Aceves, Jose Ruiz-Pinales, and Rodrigo Correa, "Deep Learning-based Coronary Stenosis Detection in X-ray Angiography Images: Overview and Future Trends." Artificial Intelligence and Machine Learning for Healthcare: Vol. 2: Emerging Methodologies and Trends, pp. 197-223, (2022).
14- Kun Pang, Danni Ai, Huihui Fang, Jingfan Fan, Hong Song, and Jian Yang, "Stenosis-DetNet: Sequence consistency-based stenosis detection for X-ray coronary angiography." Computerized Medical Imaging and Graphics, Vol. 89p. 101900, (2021).
15- Viacheslav V Danilov et al., "Real-time coronary artery stenosis detection based on modern neural networks." Scientific reports, Vol. 11 (No. 1), p. 7582, (2021).
16- X. Li et al., "STQD-Det: Spatio-Temporal Quantum Diffusion Model for Real-Time Coronary Stenosis Detection in X-Ray Angiography." IEEE Transactions on Pattern Analysis and Machine Intelligence, Vol. 46 (No. 12), pp. 9908-20, (2024).
17- Jong Hak Moon, Won Chul Cha, Myung Jin Chung, Kyu-Sung Lee, Baek Hwan Cho, and Jin Ho Choi, "Automatic stenosis recognition from coronary angiography using convolutional neural networks." Computer methods and programs in biomedicine, Vol. 198p. 105819, (2021).
18- Karol Antczak and Łukasz Liberadzki, "Stenosis detection with deep convolutional neural networks." in MATEC web of conferences, (2018), Vol. 210: EDP Sciences, p. 04001.
19- Emmanuel Ovalle-Magallanes, Juan Gabriel Avina-Cervantes, Ivan Cruz-Aceves, and Jose Ruiz-Pinales, "Transfer learning for stenosis detection in X-ray coronary angiography." Mathematics, Vol. 8 (No. 9), p. 1510, (2020).
20- Hafsa Ouchra and Abdessamad Belangour, "Object detection approaches in images: a survey." in Thirteenth International Conference on Digital Image Processing (ICDIP 2021), (2021), Vol. 11878: SPIE, pp. 132-41.
21- N Bilous, V Malko, M Frohme, and A Nechyporenko, "Comparison of CNN-Based Architectures for Detection of Different Object Classes. AI 2024, 5, 2300–2320." ed, (2024).
22- Samain Abid, Muhammad Haris, Mansoor Iqbal, Nadia Khan, Khalid Munir, and Hamza Yousaf, "Comparative Analysis of Machine Learning Pre-Trained Object Detection Models: Performance, Efficiency, and Application Suitabilit." in 2024 International Conference on Electrical, Communication and Computer Engineering (ICECCE), (2024): IEEE, pp. 1-6.
23- Zihao Zhou, Yang Li, Chenglei Peng, Hanrong Wang, and Sidan Du, "Image processing: Facilitating retinanet for detecting small objects." in Journal of Physics: Conference Series, (2021), Vol. 1815 (No. 1): IOP Publishing, p. 012016.
24- Tsung-Yi Lin, Piotr Dollár, Ross Girshick, Kaiming He, Bharath Hariharan, and Serge Belongie, "Feature pyramid networks for object detection." in Proceedings of the IEEE conference on computer vision and pattern recognition, (2017), pp. 2117-25.
25- Tsung-Yi Lin, Priya Goyal, Ross Girshick, Kaiming He, and Piotr Dollár, "Focal loss for dense object detection." in Proceedings of the IEEE international conference on computer vision, (2017), pp. 2980-88.
26- Mingxing Tan, Ruoming Pang, and Quoc V Le, "Efficientdet: Scalable and efficient object detection." in Proceedings of the IEEE/CVF conference on computer vision and pattern recognition, (2020), pp. 10781-90.
27- Dan Munteanu, Diana Moina, Cristina Gabriela Zamfir, Ștefan Mihai Petrea, Dragos Sebastian Cristea, and Nicoleta Munteanu, "Sea mine detection framework using YOLO, SSD and EfficientDet deep learning models." Sensors, Vol. 22 (No. 23), p. 9536, (2022).
28- Brett Koonce and Brett Koonce, "EfficientNet." Convolutional neural networks with swift for Tensorflow: image recognition and dataset categorization, pp. 109-23, (2021).
29- Vinayak Tiwari, Amit Singhal, and Nischay Dhankhar, "Detecting COVID-19 Opacity in X-ray Images Using YOLO and RetinaNet Ensemble." in 2022 IEEE Delhi Section Conference (DELCON), (2022): IEEE, pp. 1-5.
30- Carina Isabel Andrade Albuquerque, "Object Detection in medical imaging." (2023).
31- Ming Zhou, Bo Li, and Jue Wang, "Optimization of Hyperparameters in Object Detection Models Based on Fractal Loss Function." Fractal and Fractional, Vol. 6 (No. 12), p. 706, (2022).
32- Fengkai Wan, "Deep Learning Method Used in Skin Lesions Segmentation and Classification." ed, (2018).
33- Mohammed Noman, Vladimir Stankovic, and Ayman Tawfik, "Object detection techniques: Overview and performance comparison." in 2019 IEEE International Symposium on Signal Processing and Information Technology (ISSPIT), (2019): IEEE, pp. 1-5.
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IssueVol 13 No 2 (2026) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/fbt.v13i2.21947
Keywords
Object Detection Deep Learning Medical Image Coronary Angiography Digital Medicine

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How to Cite
1.
Keshavarz H, Sadr H, Nazari M, Salari A. Facilitating Timely Decision-Making in Healthcare: an Object Detection Approach for Automated Coronary Artery Stenosis Detection. Frontiers Biomed Technol. 2026;13(2):508-519.