A Hybrid Energy Model for Region Based Curve Evolution - Application to CTA Coronary Segmentation

Background and Objective: State-of-the-art medical imaging techniques have enabled non-invasive imaging of the internal organs. However, high volumes of imaging data make manual interpretation and delineation of abnormalities cumbersome for clinicians. These challenges have driven intensive research into efficient medical image segmentation. In this work, we propose a hybrid region-based energy formulation for effective segmentation in computed tomography angiography (CTA) imagery. Methods: The proposed hybrid energy couples an intensity-based local term with an efficient discontinuity-based global model of the image for optimal segmentation. The segmentation is achieved using a level set formulation due to the computational robustness. After validating the statistical significance of the hybrid energy, we applied the proposed model to solve an important clinical problem of 3D coronary segmentation. An improved seed detection method is used to initialize the level set evolution. Moreover, we employed an auto-correction feature that captures the emerging peripheries during the curve evolution for completeness of the coronary tree. Results: We evaluated the segmentation accuracy of the proposed energy model against the existing techniques in two stages. Qualitative and quantitative results demonstrate the effectiveness of the proposed framework with a consistent mean sensitivity and specificity measures of 80% across the CTA data. Moreover, a high degree of agreement with respect to the inter-observer differences justifies the generalization of the proposed method. Conclusions: The proposed method is effective to segment the coronary tree from the CTA volume based on hybrid image based energy, which can improve the clinicians ability to detect arterial abnormalities

Robust semi-automated path extraction for visualising stenosis of the coronary arteries

Computed tomography angiography (CTA) is useful for diagnosing and planning treatment of heart disease. However, contrast agent in surrounding structures (such as the aorta and left ventricle) makes 3-D visualisation of the coronary arteries difficult. This paper presents a composite method employing segmentation and volume rendering to overcome this issue. A key contribution is a novel Fast Marching minimal path cost function for vessel centreline extraction. The resultant centreline is used to compute a measure of vessel lumen, which indicates the degree of stenosis (narrowing of a vessel). Two volume visualisation techniques are presented which utilise the segmented arteries and lumen measure. The system is evaluated and demonstrated using synthetic and clinically obtained datasets

Blood Vessel Segmentation and shape analysis for quantification of Coronary Artery Stenosis in CT Angiography

This thesis presents an automated framework for quantitative vascular shape analysis of the coronary arteries, which constitutes an important and fundamental component of an automated image-based diagnostic system. Firstly, an automated vessel segmentation algorithm is developed to extract the coronary arteries based on the framework of active contours. Both global and local intensity statistics are utilised in the energy functional calculation, which allows for dealing with non-uniform brightness conditions, while evolving the contour towards to the desired boundaries without being trapped in local minima. To suppress kissing vessel artifacts, a slice-by-slice correction scheme, based on multiple regions competition, is proposed to identify and track the kissing vessels throughout the transaxial images of the CTA data. Based on the resulting segmentation, we then present a dedicated algorithm to estimate the geometric parameters of the extracted arteries, with focus on vessel bifurcations. In particular, the centreline and associated reference surface of the coronary arteries, in the vicinity of arterial bifurcations, are determined by registering an elliptical cross sectional tube to the desired constituent branch. The registration problem is solved by a hybrid optimisation method, combining local greedy search and dynamic programming, which ensures the global optimality of the solution and permits the incorporation of any hard constraints posed to the tube model within a natural and direct framework. In contrast with conventional volume domain methods, this technique works directly on the mesh domain, thus alleviating the need for image upsampling. The performance of the proposed framework, in terms of efficiency and accuracy, is demonstrated on both synthetic and clinical image data. Experimental results have shown that our techniques are capable of extracting the major branches of the coronary arteries and estimating the related geometric parameters (i.e., the centreline and the reference surface) with a high degree of agreement to those obtained through manual delineation. Particularly, all of the major branches of coronary arteries are successfully detected by the proposed technique, with a voxel-wise error at 0.73 voxels to the manually delineated ground truth data. Through the application of the slice-by-slice correction scheme, the false positive metric, for those coronary segments affected by kissing vessel artifacts, reduces from 294% to 22.5%. In terms of the capability of the presented framework in defining the location of centrelines across vessel bifurcations, the mean square errors (MSE) of the resulting centreline, with respect to the ground truth data, is reduced by an average of 62.3%, when compared with initial estimation obtained using a topological thinning based algorithm

Framework for Detection and Localization of Coronary Non-Calcified Plaques in Cardiac CTA using Mean Radial Profiles

Background and Objective: The high mortality rate associated with coronary heart disease (CHD) has driven intensive research in cardiac imaging and image analysis. The advent of computed tomography angiography (CTA) has turned non-invasive diagnosis of cardiovascular anomalies into reality as calcified coronary plaques can be easily identified due to their high intensity values. However, the detection of non-calcified plaques in CTA is still a challenging problem because of lower intensity values, which are often similar to the nearby blood and muscle tissues. In this work, we propose the use of mean radial profiles for the detection of non-calcified plaques in CTA imagery. Methods: Accordingly, we computed radial profiles by averaging the image intensity in concentric rings around the vessel centreline in a first stage. In the subsequent stage, an SVM classifier is applied to identify the abnormal coronary segments. For occluded segments, we further propose a derivative-based method to localize the position and length of the plaque inside the segment. Results: A total of 32 CTA volumes were analysed and a detection accuracy of 88.4% with respect to the manual expert was achieved. The plaque localization accuracy was computed using the Dice similarity coefficient and a mean of 83.2% was achieved. Conclusion: The consistent performance for multi-vendor, multi-institution data demonstrates the reproducibility of our method across different CTA datasets with a good agreement with manual expert annotations

Framework for Detection and Localization of Coronary Non-Calcified Plaques in Cardiac CTA using Mean Radial Profiles

Background and Objective: The high mortality rate associated with coronary heart disease (CHD) has driven intensive research in cardiac imaging and image analysis. The advent of computed tomography angiography (CTA) has turned non-invasive diagnosis of cardiovascular anomalies into reality as calcified coronary plaques can be easily identified due to their high intensity values. However, the detection of non-calcified plaques in CTA is still a challenging problem because of lower intensity values, which are often similar to the nearby blood and muscle tissues. In this work, we propose the use of mean radial profiles for the detection of non-calcified plaques in CTA imagery. Methods: Accordingly, we computed radial profiles by averaging the image intensity in concentric rings around the vessel centreline in a first stage. In the subsequent stage, an SVM classifier is applied to identify the abnormal coronary segments. For occluded segments, we further propose a derivative-based method to localize the position and length of the plaque inside the segment. Results: A total of 32 CTA volumes were analysed and a detection accuracy of 88.4% with respect to the manual expert was achieved. The plaque localization accuracy was computed using the Dice similarity coefficient and a mean of 83.2% was achieved. Conclusion: The consistent performance for multi-vendor, multi-institution data demonstrates the reproducibility of our method across different CTA datasets with a good agreement with manual expert annotations

Detection, localization and quantification of non-calcified coronary plaques in contrast enhanced CT angiography

State-of-the-art imaging equipment has increased clinician's ability to make non-invasive diagnoses of coronary heart disease (CHD); however, high volumes of imaging data make manual abnormality detection cumbersome in practice. In addition, the interpretation of CTA heavily relies upon the previous knowledge of the clinician. These limitations have driven an intense research in the context of automated solutions for fast, reliable and accurate diagnosis. Accordingly, in this thesis, we present an automated framework for detection, localization and quantification of the non-calcified coronary plaques in cardiac computed tomography angiography (CTA). The first contribution of the thesis is a coronary segmentation algorithm that is adaptive to the contrast agent and employs a hybrid energy incorporating local and global image statistics in a segmentation framework using partial differential equations (PDEs). Accordingly, we illustrated with the help of experimental evidence that a volume-specific intensity threshold leads to an improved segmentation in CTA. In the subsequent step, we employed a hybrid region-based energy for improved segmentation in CTA imagery. The hybrid energy couples an intensity-based local term with an efficient discontinuity-based global model of the image for optimal segmentation. The proposed method is less sensitive to the local optima problem and helps in reducing false positives, as well as it allows a certain degree of freedom for the initialization. Moreover, we employed an auto-correction feature for improved segmentation, as an auto-corrected mask captures the emerging peripheries of the coronary tree during the curve evolution. The effectiveness of the proposed model is demonstrated with the help of both qualitative and quantitative results, with a mean accuracy of 80% across the CTA dataset. The capability to address the variations in initial mask and localization radii simultaneously, makes our algorithm a feasible choice for coronary segmentation. The second contribution of the thesis is an automatic approach to analyse the segmented coronary tree for the presence of non-calcified plaques. The specific focus of this work is detection of non-calcified plaques in CTA, as intensity overlap between blood, fat and non-calcified plaques make the detection challenging. Non-calcified plaques are identified based on mean radial profiles that average the image intensities in concentric rings around the vessel centreline. Subsequently, an SVM classifier is applied to differentiate the abnormal coronary segments from normal ones. A total of 32 CTA volumes have been analysed and a detection accuracy of 88.4% with respect to the manual expert has been achieved. For plaque-affected segments, we further proposed a derivative-based method to localize the position and length of the plaque inside the segment. The plaque localization accuracy has been around 83.2%. Moreover, the proposed model has been tested on three different CTA datasets and has produced consistent results, demonstrating its reproducibility for generic CTA data. The final contribution of the thesis is a method to segment and quantify the non-calcified plaque. After evaluating the vessel wall thickness, posterior probability based voxel classification has been performed to quantify the lumen and plaque, respectively. Both qualitative and quantitative results demonstrate that the proposed model shows a good agreement with three independent experts. To optimize the processing time, we employed sparse field method in a level-set based active contour evolution

3D vasculature segmentation using localized hybrid level-set method

Background: Intensity inhomogeneity occurs in many medical images, especially in vessel images. Overcoming the difficulty due to image inhomogeneity is crucial for the segmentation of vessel image. Methods: This paper proposes a localized hybrid level-set method for the segmentation of 3D vessel image. The proposed method integrates both local region information and boundary information for vessel segmentation, which is essential for the accurate extraction of tiny vessel structures. The local intensity information is firstly embedded into a region-based contour model, and then incorporated into the level-set formulation of the geodesic active contour model. Compared with the preset global threshold based method, the use of automatically calculated local thresholds enables the extraction of the local image information, which is essential for the segmentation of vessel images. Results: Experiments carried out on the segmentation of 3D vessel images demonstrate the strengths of using locally specified dynamic thresholds in our level-set method. Furthermore, both qualitative comparison and quantitative validations have been performed to evaluate the effectiveness of our proposed model. Conclusions: Experimental results and validations demonstrate that our proposed model can achieve more promising segmentation results than the original hybrid method does

Human treelike tubular structure segmentation: A comprehensive review and future perspectives

Various structures in human physiology follow a treelike morphology, which often expresses complexity at very fine scales. Examples of such structures are intrathoracic airways, retinal blood vessels, and hepatic blood vessels. Large collections of 2D and 3D images have been made available by medical imaging modalities such as magnetic resonance imaging (MRI), computed tomography (CT), Optical coherence tomography (OCT) and ultrasound in which the spatial arrangement can be observed. Segmentation of these structures in medical imaging is of great importance since the analysis of the structure provides insights into disease diagnosis, treatment planning, and prognosis. Manually labelling extensive data by radiologists is often time-consuming and error-prone. As a result, automated or semi-automated computational models have become a popular research field of medical imaging in the past two decades, and many have been developed to date. In this survey, we aim to provide a comprehensive review of currently publicly available datasets, segmentation algorithms, and evaluation metrics. In addition, current challenges and future research directions are discussed

Automated quantification of non-calcified coronary plaques in cardiac CT angiographic imagery

The high mortality rate associated with coronary heart disease (CHD) has driven intensive research in cardiac image analysis. The advent of computed tomography angiography (CTA) has turned non-invasive diagnosis of cardiovascular anomalies into reality as calcified coronary plaques can be easily identified due to high intensity values. However, detection and quantification of the non-calcified plaques in CTA is still a challenging problem because of their lower intensity values, which are often similar to the nearby blood and muscle tissues. In this work, we propose Bayesian posterior based model for precise quantification of the non-calcified plaques in CTA imagery. The only indicator of non-calcified plaques in CTA is relatively lower intensity. Hence, we exploited intensity variations to discriminate voxels into lumen and plaque classes. Based on the normal coronary segments, we computed the vessel-wall thickness in first step. In the subsequent step, we removed vessel wall from the segmented tree and employed Gaussian Mixture Model to compute optimal distribution parameters. In the final step, distribution parameters were employed in Bayesian posterior model to classify voxels into lumen or plaque. A total of 18 CTA volumes were analyzed in this work using two different approaches. According to the experimental results, mean Jaccard overlap is around 88% with respect to the manual expert. In terms of sensitivity, specificity and accuracy, the proposed method achieves 84.13%, 79.15% and 82.02% success, respectively. Conclusion: According to the experimental results, it is shown that the proposed plaque quantification method achieves accuracy equivalent to human experts

Human Treelike Tubular Structure Segmentation: A Comprehensive Review and Future Perspectives

Various structures in human physiology follow a treelike morphology, which often expresses complexity at very fine scales. Examples of such structures are intrathoracic airways, retinal blood vessels, and hepatic blood vessels. Large collections of 2D and 3D images have been made available by medical imaging modalities such as magnetic resonance imaging (MRI), computed tomography (CT), Optical coherence tomography (OCT) and ultrasound in which the spatial arrangement can be observed. Segmentation of these structures in medical imaging is of great importance since the analysis of the structure provides insights into disease diagnosis, treatment planning, and prognosis. Manually labelling extensive data by radiologists is often time-consuming and error-prone. As a result, automated or semi-automated computational models have become a popular research field of medical imaging in the past two decades, and many have been developed to date. In this survey, we aim to provide a comprehensive review of currently publicly available datasets, segmentation algorithms, and evaluation metrics. In addition, current challenges and future research directions are discussed.Comment: 30 pages, 19 figures, submitted to CBM journa