Coronary Artery Segmentation and Motion Modelling

Conventional coronary artery bypass surgery requires invasive sternotomy and the use of a cardiopulmonary bypass, which leads to long recovery period and has high infectious potential. Totally endoscopic coronary artery bypass (TECAB) surgery based on image guided robotic surgical approaches have been developed to allow the clinicians to conduct the bypass surgery off-pump with only three pin holes incisions in the chest cavity, through which two robotic arms and one stereo endoscopic camera are inserted. However, the restricted field of view of the stereo endoscopic images leads to possible vessel misidentification and coronary artery mis-localization. This results in 20-30% conversion rates from TECAB surgery to the conventional approach. We have constructed patient-specific 3D + time coronary artery and left ventricle motion models from preoperative 4D Computed Tomography Angiography (CTA) scans. Through temporally and spatially aligning this model with the intraoperative endoscopic views of the patient's beating heart, this work assists the surgeon to identify and locate the correct coronaries during the TECAB precedures. Thus this work has the prospect of reducing the conversion rate from TECAB to conventional coronary bypass procedures. This thesis mainly focus on designing segmentation and motion tracking methods of the coronary arteries in order to build pre-operative patient-specific motion models. Various vessel centreline extraction and lumen segmentation algorithms are presented, including intensity based approaches, geometric model matching method and morphology-based method. A probabilistic atlas of the coronary arteries is formed from a group of subjects to facilitate the vascular segmentation and registration procedures. Non-rigid registration framework based on a free-form deformation model and multi-level multi-channel large deformation diffeomorphic metric mapping are proposed to track the coronary motion. The methods are applied to 4D CTA images acquired from various groups of patients and quantitatively evaluated

Optimized Adaptive Frangi-based Coronary Artery Segmentation using Genetic Algorithm

Diseases of coronary artery are deliberated as one of the most common heart diseases leading to death worldwide. For early detection of such disease, the X-ray angiography is a benchmark imaging modality for diagnosing such illness. The acquired X-ray angiography images usually suffer from low quality and the presence of noise. Therefore, for developing a computer-aided diagnosis (CAD) system, vessel enhancement and segmentation play significant role. In this paper, an optimized adapter filter based on Frangi filter was proposed for superior segmentation of the angiography images using genetic algorithm (GA). The original angiography image is initially preprocessed to enhance its contrast followed by generating the vesselness map using the proposed optimized Frangi filter. Then, a segmentation technique is applied to extract only the artery vessels, where the proposed system for extracting only the main vessel was evaluated. The experimental results on angiography images established the superiority of the vessel regions extraction showing 98.58% accuracy compared to the state-of-the-art

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

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

Accurate Segmentation of Cerebrovasculature from TOF-MRA Images Using Appearance Descriptors

© 2013 IEEE. Analyzing cerebrovascular changes can significantly lead to not only detecting the presence of serious diseases e.g., hypertension and dementia, but also tracking their progress. Such analysis could be better performed using Time-of-Flight Magnetic Resonance Angiography (ToF-MRA) images, but this requires accurate segmentation of the cerebral vasculature from the surroundings. To achieve this goal, we propose a fully automated cerebral vasculature segmentation approach based on extracting both prior and current appearance features that have the ability to capture the appearance of macro and micro-vessels in ToF-MRA. The appearance prior is modeled with a novel translation and rotation invariant Markov-Gibbs Random Field (MGRF) of voxel intensities with pairwise interaction analytically identified from a set of training data sets. The appearance of the cerebral vasculature is also represented with a marginal probability distribution of voxel intensities by using a Linear Combination of Discrete Gaussians (LCDG) that its parameters are estimated by using a modified Expectation-Maximization (EM) algorithm. The extracted appearance features are separable and can be classified by any classifier, as demonstrated by our segmentation results. To validate the accuracy of our algorithm, we tested the proposed approach on in-vivo data using 270 data sets, which were qualitatively validated by a neuroradiology expert. The results were quantitatively validated using the three commonly used metrics for segmentation evaluation: the Dice coefficient, the modified Hausdorff distance, and the absolute volume difference. The proposed approach showed a higher accuracy compared to two of the existing segmentation approaches

Computerized Analysis of Magnetic Resonance Images to Study Cerebral Anatomy in Developing Neonates

The study of cerebral anatomy in developing neonates is of great importance for the understanding of brain development during the early period of life. This dissertation therefore focuses on three challenges in the modelling of cerebral anatomy in neonates during brain development. The methods that have been developed all use Magnetic Resonance Images (MRI) as source data. To facilitate study of vascular development in the neonatal period, a set of image analysis algorithms are developed to automatically extract and model cerebral vessel trees. The whole process consists of cerebral vessel tracking from automatically placed seed points, vessel tree generation, and vasculature registration and matching. These algorithms have been tested on clinical Time-of- Flight (TOF) MR angiographic datasets. To facilitate study of the neonatal cortex a complete cerebral cortex segmentation and reconstruction pipeline has been developed. Segmentation of the neonatal cortex is not effectively done by existing algorithms designed for the adult brain because the contrast between grey and white matter is reversed. This causes pixels containing tissue mixtures to be incorrectly labelled by conventional methods. The neonatal cortical segmentation method that has been developed is based on a novel expectation-maximization (EM) method with explicit correction for mislabelled partial volume voxels. Based on the resulting cortical segmentation, an implicit surface evolution technique is adopted for the reconstruction of the cortex in neonates. The performance of the method is investigated by performing a detailed landmark study. To facilitate study of cortical development, a cortical surface registration algorithm for aligning the cortical surface is developed. The method first inflates extracted cortical surfaces and then performs a non-rigid surface registration using free-form deformations (FFDs) to remove residual alignment. Validation experiments using data labelled by an expert observer demonstrate that the method can capture local changes and follow the growth of specific sulcus

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

Fast catheter segmentation and tracking based on x-ray fluoroscopic and echocardiographic modalities for catheter-based cardiac minimally invasive interventions

X-ray fluoroscopy and echocardiography imaging (ultrasound, US) are two imaging modalities that are widely used in cardiac catheterization. For these modalities, a fast, accurate and stable algorithm for the detection and tracking of catheters is required to allow clinicians to observe the catheter location in real-time. Currently X-ray fluoroscopy is routinely used as the standard modality in catheter ablation interventions. However, it lacks the ability to visualize soft tissue and uses harmful radiation. US does not have these limitations but often contains acoustic artifacts and has a small field of view. These make the detection and tracking of the catheter in US very challenging. The first contribution in this thesis is a framework which combines Kalman filter and discrete optimization for multiple catheter segmentation and tracking in X-ray images. Kalman filter is used to identify the whole catheter from a single point detected on the catheter in the first frame of a sequence of x-ray images. An energy-based formulation is developed that can be used to track the catheters in the following frames. We also propose a discrete optimization for minimizing the energy function in each frame of the X-ray image sequence. Our approach is robust to tangential motion of the catheter and combines the tubular and salient feature measurements into a single robust and efficient framework. The second contribution is an algorithm for catheter extraction in 3D ultrasound images based on (a) the registration between the X-ray and ultrasound images and (b) the segmentation of the catheter in X-ray images. The search space for the catheter extraction in the ultrasound images is constrained to lie on or close to a curved surface in the ultrasound volume. The curved surface corresponds to the back-projection of the extracted catheter from the X-ray image to the ultrasound volume. Blob-like features are detected in the US images and organized in a graphical model. The extracted catheter is modelled as the optimal path in this graphical model. Both contributions allow the use of ultrasound imaging for the improved visualization of soft tissue. However, X-ray imaging is still required for each ultrasound frame and the amount of X-ray exposure has not been reduced. The final contribution in this thesis is a system that can track the catheter in ultrasound volumes automatically without the need for X-ray imaging during the tracking. Instead X-ray imaging is only required for the system initialization and for recovery from tracking failures. This allows a significant reduction in the amount of X-ray exposure for patient and clinicians.Open Acces