Initialization, noise, singularities, and scale in height ridge traversal for tubular object centerline extraction

VesselBoost: A Python Toolbox for Small Blood Vessel Segmentation in Human Magnetic Resonance Angiography Data

Magnetic resonance angiography (MRA) performed at ultra-high magnetic field provides a unique opportunity to study the arteries of the living human brain at the mesoscopic level. From this, we can gain new insights into the brain's blood supply and vascular disease affecting small vessels. However, for quantitative characterization and precise representation of human angioarchitecture to, for example, inform blood-flow simulations, detailed segmentations of the smallest vessels are required. Given the success of deep learning-based methods in many segmentation tasks, we here explore their application to high-resolution MRA data, and address the difficulty of obtaining large data sets of correctly and comprehensively labelled data. We introduce VesselBoost, a vessel segmentation package, which utilizes deep learning and imperfect training labels for accurate vasculature segmentation. Combined with an innovative data augmentation technique, which leverages the resemblance of vascular structures, VesselBoost enables detailed vascular segmentations.

COACT: Coronary artery centerline tracker

BACKGROUND

The curved planar reformation (CPR) technique is one of the most commonly used methods in clinical practice to locate coronary arteries in medical images.

PURPOSE

The artery centerline is the cornerstone for the generation of the CPR image. Here, we describe the development of a new fully automatic artery centerline tracker with the aim of increasing the efficiency and accuracy of the process.

METHODS

We propose a COronary artery Centerline Tracker (COACT) framework which consists of an ostium point finder (OPFinder) model, an intersection point detector (IPDetector) model and a set of centerline tracking strategies. The output of OPFinder is the ostium points. The function of the IPDetector is to predict the intersections of a sample sphere and the centerlines. The centerline tracking process starts from two ostium points detected by the OPFinder, and combines the results of the IPDetector with a series of strategies to gradually reconstruct the coronary artery centerline tree.

RESULTS

Two coronary CT angiography (CCTA) datasets were used to validate the models. Dataset1 contains 160 cases (32 for test and 128 for training) and dataset2 contains 70 cases (20 for test and 50 for training). The results show that the average distance between the ostium points predicted by the OPFinder and the manually annotated ostium points was 0.88 mm, which is similar to the differences between the results obtained by two observers (0.85 mm). For the IPDetector, the average overlap of the predicted and ground truth intersection points was 97.82% and this is also close to the inter-observer agreement of 98.50%. For the entire coronary centerline tree, the overlap between the results obtained by COACT and the gold standard was 94.33%, which is slightly lower than the inter-observer agreement, 98.39%.

CONCLUSIONS

We have developed a fully automatic centerline tracking method for CCTA scans and achieved a satisfactory result. The proposed algorithms are also incorporated in the medical image analysis platform TIMESlice (https://slice-doc.netlify.app) for further studies.

Contour attention network for cerebrovascular segmentation from TOF-MRA volumetric images

BACKGROUND

Cerebrovascular segmentation is a crucial step in the computer-assisted diagnosis of cerebrovascular pathologies. However, accurate extraction of cerebral vessels from time-of-flight magnetic resonance angiography (TOF-MRA) data is still challenging due to the complex topology and slender shape.

PURPOSE

The existing deep learning-based approaches pay more attention to the skeleton and ignore the contour, which limits the segmentation performance of the cerebrovascular structure. We aim to weight the contour of brain vessels in shallow features when concatenating with deep features. It helps to obtain more accurate cerebrovascular details and narrows the semantic gap between multilevel features.

METHODS

This work proposes a novel framework for priority extraction of contours in cerebrovascular structures. We first design a neighborhood-based algorithm to generate the ground truth of the cerebrovascular contour from original annotations, which can introduce useful shape information for the segmentation network. Moreover, We propose an encoder-dual decoder-based contour attention network (CA-Net), which consists of the dilated asymmetry convolution block (DACB) and the Contour Attention Module (CAM). The ancillary decoder uses the DACB to obtain cerebrovascular contour features under the supervision of contour annotations. The CAM transforms these features into a spatial attention map to increase the weight of the contour voxels in main decoder to better restored the vessel contour details.

RESULTS

The CA-Net is thoroughly validated using two publicly available datasets, and the experimental results demonstrate that our network outperforms the competitors for cerebrovascular segmentation. We achieved the average dice similarity coefficient (D S C $DSC$ ) of 68.15 and 99.92% in natural and synthetic datasets. Our method segments cerebrovascular structures with better completeness.

CONCLUSIONS

We propose a new framework containing contour annotation generation and cerebrovascular segmentation network that better captures the tiny vessels and improve vessel connectivity.

TL-MSE2-Net: Transfer learning based nested model for cerebrovascular segmentation with aneurysms

Cerebrovascular (i.e., cerebral vessel) segmentation is essential for diagnosing and treating brain diseases. Convolutional neural network models, such as U-Net, are commonly used for this purpose. Unfortunately, such models may not be entirely satisfactory in dealing with cerebrovascular segmentation with tumors due to the following issues: (1) Relatively small number of clinical datasets from patients obtained through different modalities such as computed tomography (CT) and magnetic resonance imaging (MRI), leading to inadequate training and lack of transferability in the modeling; (2) Insufficient feature extraction caused by less attention to both convolution sizes and cerebral vessel edges. Inspired by the existence of similar features on cerebral vessels between normal subjects and patients, we propose a transfer learning strategy based on a pre-trained nested model called TL-MSE2-Net. This model uses one of the publicly available datasets for cerebrovascular segmentation with aneurysms. To address issue (1), our transfer learning strategy leverages a pre-trained model that uses a large number of datasets from normal subjects, providing a potential solution to the lack of sufficient clinical datasets. To tackle issue (2), we structure the pre-trained model based on 3D U-Net, comprising three blocks: ResMul, DeRes, and REAM. The ResMul and DeRes blocks enhance feature extraction by utilizing multiple convolution sizes to capture multiscale features, and the REAM block increases the weight of the voxels on the edges of the given 3D volume. We evaluated the proposed model on one small private clinical dataset and two publicly available datasets. The experimental results demonstrated that our MSE2-Net framework achieved an average Dice score of 70.81 % and 89.08 % on the two publicly available datasets, outperforming other state-of-the-art methods. Ablation studies were also conducted to validate the effectiveness of each block. The proposed TL-MSE2-Net yielded better results than MSE2-Net on a small private clinical dataset, with increases of 5.52 %, 3.37 %, 6.71 %, and 0.85 % for the Dice score, sensitivity, Jaccard index, and precision, respectively.

ImageCAS: A large-scale dataset and benchmark for coronary artery segmentation based on computed tomography angiography images

Cardiovascular disease (CVD) accounts for about half of non-communicable diseases. Vessel stenosis in the coronary artery is considered to be the major risk of CVD. Computed tomography angiography (CTA) is one of the widely used noninvasive imaging modalities in coronary artery diagnosis due to its superior image resolution. Clinically, segmentation of coronary arteries is essential for the diagnosis and quantification of coronary artery disease. Recently, a variety of works have been proposed to address this problem. However, on one hand, most works rely on in-house datasets, and only a few works published their datasets to the public which only contain tens of images. On the other hand, their source code have not been published, and most follow-up works have not made comparison with existing works, which makes it difficult to judge the effectiveness of the methods and hinders the further exploration of this challenging yet critical problem in the community. In this paper, we propose a large-scale dataset for coronary artery segmentation on CTA images. In addition, we have implemented a benchmark in which we have tried our best to implement several typical existing methods. Furthermore, we propose a strong baseline method which combines multi-scale patch fusion and two-stage processing to extract the details of vessels. Comprehensive experiments show that the proposed method achieves better performance than existing works on the proposed large-scale dataset. The benchmark and the dataset are published at https://github.com/XiaoweiXu/ImageCAS-A-Large-Scale-Dataset-and-Benchmark-for-Coronary-Artery-Segmentation-based-on-CT.

Prior skeleton based online deep reinforcement learning for coronary artery centerline extraction

Coronary centerline extraction is an essential technique for X-ray coronary angiography (XCA) image analysis, which provides qualitative and quantitative guidance for percutaneous coronary intervention (PCI). In this paper, an online deep reinforcement learning method for coronary centerline extraction is proposed based on the prior vascular skeleton. Firstly, with XCA image preprocessing (foreground extraction and vessel segmentation) results, the improved ZhangSuen image thinning algorithm is used to rapidly extract the preliminary vascular skeleton network. On this basis, according to the spatial-temporal and morphological continuity of the angiography image sequence, the connectivity of different branches is determined using k-means clustering, and the vessel segments are then grouped, screened, and reconnected to obtain the aorta and its major branches. Finally, using the previous results as prior information, an online Deep Q-Network (DQN) reinforcement learning method is proposed to optimize each branch simultaneously. It comprehensively considers grayscale intensity and eigenvector continuity to achieve the combination of data-driven and model-driven without pre-training. Experimental results on clinical images and the third-party dataset demonstrate that the proposed method can accurately extract, restructure, and optimize the centerline of XCA images with a higher overall accuracy than the existing state-of-the-art methods.

Neuron tracing from light microscopy images: automation, deep learning and bench testing

MOTIVATION

Large-scale neuronal morphologies are essential to neuronal typing, connectivity characterization and brain modeling. It is widely accepted that automation is critical to the production of neuronal morphology. Despite previous survey papers about neuron tracing from light microscopy data in the last decade, thanks to the rapid development of the field, there is a need to update recent progress in a review focusing on new methods and remarkable applications.

RESULTS

This review outlines neuron tracing in various scenarios with the goal to help the community understand and navigate tools and resources. We describe the status, examples and accessibility of automatic neuron tracing. We survey recent advances of the increasingly popular deep-learning enhanced methods. We highlight the semi-automatic methods for single neuron tracing of mammalian whole brains as well as the resulting datasets, each containing thousands of full neuron morphologies. Finally, we exemplify the commonly used datasets and metrics for neuron tracing bench testing.

CT-derived vessel segmentation for analysis of post-radiation therapy changes in vasculature and perfusion

Vessel segmentation in the lung is an ongoing challenge. While many methods have been able to successfully identify vessels in normal, healthy, lungs, these methods struggle in the presence of abnormalities. Following radiotherapy, these methods tend to identify regions of radiographic change due to post-radiation therapytoxicities as vasculature falsely. By combining texture analysis and existing vasculature and masking techniques, we have developed a novel vasculature segmentation workflow that improves specificity in irradiated lung while preserving the sensitivity of detection in the rest of the lung. Furthermore, radiation dose has been shown to cause vascular injury as well as reduce pulmonary function post-RT. This work shows the improvements our novel vascular segmentation method provides relative to existing methods. Additionally, we use this workflow to show a dose dependent radiation-induced change in vasculature which is correlated with previously measured perfusion changes (R² = 0.72) in both directly irradiated and indirectly damaged regions of perfusion. These results present an opportunity to extend non-contrast CT-derived models of functional change following radiation therapy.

Acoustic Molecular Imaging Beyond the Diffraction Limit In Vivo

Ultrasound molecular imaging (USMI) is a technique used to noninvasively estimate the distribution of molecular markers in vivo by imaging microbubble contrast agents (MCAs) that have been modified to target receptors of interest on the vascular endothelium. USMI is especially relevant for preclinical and clinical cancer research and has been used to predict tumor malignancy and response to treatment. In the last decade, methods that improve the resolution of contrast-enhanced ultrasound by an order of magnitude and allow researchers to noninvasively image individual capillaries have emerged. However, these approaches do not translate directly to molecular imaging. In this work, we demonstrate super-resolution visualization of biomarker expression in vivo using superharmonic ultrasound imaging (SpHI) with dual-frequency transducers, targeted contrast agents, and localization microscopy processing. We validate and optimize the proposed method in vitro using concurrent optical and ultrasound microscopy and a microvessel phantom. With the same technique, we perform a proof-of-concept experiment in vivo in a rat fibrosarcoma model and create maps of biomarker expression co-registered with images of microvasculature. From these images, we measure a resolution of 23 μm, a nearly fivefold improvement in resolution compared to previous diffraction-limited molecular imaging studies.

MRA-free intracranial vessel localization on MR vessel wall images

Analysis of vessel morphology is important in assessing intracranial atherosclerosis disease (ICAD). Recently, magnetic resonance (MR) vessel wall imaging (VWI) has been introduced to image ICAD and characterize morphology for atherosclerotic lesions. In order to automatically perform quantitative analysis on VWI data, MR angiography (MRA) acquired in the same imaging session is typically used to localize the vessel segments of interest. However, MRA may be unavailable caused by the lack or failure of the sequence in a VWI protocol. This study aims to investigate the feasibility to infer the vessel location directly from VWI. We propose to synergize an atlas-based method to preserve general vessel structure topology with a deep learning network in the motion field domain to correct the residual geometric error. Performance is quantified by examining the agreement between the extracted vessel structures from the pair-acquired and alignment-corrected angiogram, and the estimated output using a cross-validation scheme. Our proposed pipeline yields clinically feasible performance in localizing intracranial vessels, demonstrating the promise of performing vessel morphology analysis using VWI alone.

Acoustic Angiography: Superharmonic Contrast-Enhanced Ultrasound Imaging for Noninvasive Visualization of Microvasculature

Acoustic angiography is a contrast-enhanced ultrasound technique that relies on superharmonic imaging to form high-resolution, three-dimensional maps of the microvasculature. In order to obtain signal separation between tissue and contrast, acoustic angiography has been performed with dual-frequency transducers with nonoverlapping bandwidths. This enables a high contrast-to-tissue ratio, and the choice of a high frequency receiving element provides high resolution. In this chapter, we describe the technology behind acoustic angiography as well as the step-by-step implementation of this contrast enhanced microvascular imaging technique.

A nested parallel multiscale convolution for cerebrovascular segmentation

PURPOSE

Cerebrovascular segmentation in magnetic resonance imaging (MRI) plays an important role in the diagnosis and treatment of cerebrovascular diseases. Many segmentation frameworks based on convolutional neural networks (CNNs) or U-Net-like structures have been proposed for cerebrovascular segmentation. Unfortunately, the segmentation results are still unsatisfactory, particularly in the small/thin cerebrovascular due to the following reasons: (1) the lack of attention to multiscale features in encoder caused by the convolutions with single kernel size; (2) insufficient extraction of shallow and deep-seated features caused by the depth limitation of transmission path between encoder and decoder; (3) insufficient utilization of the extracted features in decoder caused by less attention to multiscale features.

METHODS

Inspired by U-Net++, we propose a novel 3D U-Net-like framework termed Usception for small cerebrovascular. It includes three blocks: Reduction block, Gap block, and Deep block, aiming to: (1) improve feature extraction ability by grouping different convolution sizes; (2) increase the number of multiscale features in different layers by grouping paths of different depths between encoder and decoder; (3) maximize the ability of decoder in recovering multiscale features from Reduction and Gap block by using convolutions with different kernel sizes.

RESULTS

The proposed framework is evaluated on three public and in-house clinical magnetic resonance angiography (MRA) data sets. The experimental results show that our framework reaches an average dice score of 69.29%, 87.40%, 77.77% on three data sets, which outperform existing state-of-the-art methods. We also validate the effectiveness of each block through ablation experiments.

CONCLUSIONS

By means of the combination of Inception-ResNet and dimension-expanded U-Net++, the proposed framework has demonstrated its capability to maximize multiscale feature extraction, thus achieving competitive segmentation results for small cerebrovascular.

Segmentation and Automatic Identification of Vasculature in Coronary Angiograms

Coronary angiography is the “gold standard” for the diagnosis of coronary heart disease, of which vessel segmentation and identification technologies are paid much attention to. However, because of the characteristics of coronary angiograms, such as the complex and variable morphology of coronary artery structure and the noise caused by various factors, there are many difficulties in these studies. To conquer these problems, we design a preprocessing scheme including block-matching and 3D filtering, unsharp masking, contrast-limited adaptive histogram equalization, and multiscale image enhancement to improve the quality of the image and enhance the vascular structure. To achieve vessel segmentation, we use the C-V model to extract the vascular contour. Finally, we propose an improved adaptive tracking algorithm to realize automatic identification of the vascular skeleton. According to our experiments, the vascular structures can be successfully highlighted and the background is restrained by the preprocessing scheme, the continuous contour of the vessel is extracted accurately by the C-V model, and it is verified that the proposed tracking method has higher accuracy and stronger robustness compared with the existing adaptive tracking method.

LIFE: A Generalizable Autodidactic Pipeline for 3D OCT-A Vessel Segmentation

Optical coherence tomography (OCT) is a non-invasive imaging technique widely used for ophthalmology. It can be extended to OCT angiography (OCT-A), which reveals the retinal vasculature with improved contrast. Recent deep learning algorithms produced promising vascular segmentation results; however, 3D retinal vessel segmentation remains difficult due to the lack of manually annotated training data. We propose a learning-based method that is only supervised by a self-synthesized modality named local intensity fusion (LIF). LIF is a capillary-enhanced volume computed directly from the input OCT-A. We then construct the local intensity fusion encoder (LIFE) to map a given OCT-A volume and its LIF counterpart to a shared latent space. The latent space of LIFE has the same dimensions as the input data and it contains features common to both modalities. By binarizing this latent space, we obtain a volumetric vessel segmentation. Our method is evaluated in a human fovea OCT-A and three zebrafish OCT-A volumes with manual labels. It yields a Dice score of 0.7736 on human data and 0.8594 ± 0.0275 on zebrafish data, a dramatic improvement over existing unsupervised algorithms.

Vessel network extraction and analysis of mouse pulmonary vasculature via X-ray micro-computed tomographic imaging

In this work, non-invasive high-spatial resolution three-dimensional (3D) X-ray micro-computed tomography (μCT) of healthy mouse lung vasculature is performed. Methodologies are presented for filtering, segmenting, and skeletonizing the collected 3D images. Novel methods for the removal of spurious branch artefacts from the skeletonized 3D image are introduced, and these novel methods involve a combination of distance transform gradients, diameter-length ratios, and the fast marching method (FMM). These new techniques of spurious branch removal result in the consistent removal of spurious branches without compromising the connectivity of the pulmonary circuit. Analysis of the filtered, skeletonized, and segmented 3D images is performed using a newly developed Vessel Network Extraction algorithm to fully characterize the morphology of the mouse pulmonary circuit. The removal of spurious branches from the skeletonized image results in an accurate representation of the pulmonary circuit with significantly less variability in vessel diameter and vessel length in each generation. The branching morphology of a full pulmonary circuit is characterized by the mean diameter per generation and number of vessels per generation. The methods presented in this paper lead to a significant improvement in the characterization of 3D vasculature imaging, allow for automatic separation of arteries and veins, and for the characterization of generations containing capillaries and intrapulmonary arteriovenous anastomoses (IPAVA).

Semi-automatic vessel detection for challenging cases of peripheral arterial disease

OBJECTIVES

Manual or semi-automated segmentation of the lower extremity arterial tree in patients with Peripheral arterial disease (PAD) remains a notoriously difficult and time-consuming task. The complex manifestations of the disease, including discontinuities of the vascular flow channels, the presence of calcified atherosclerotic plaque in close vicinity to adjacent bone, and the presence of metal or other imaging artifacts currently preclude fully automated vessel identification. New machine learning techniques may alleviate this challenge, but require large and reasonably well segmented training data.

METHODS

We propose a novel semi-automatic vessel tracking approach for peripheral arteries to facilitate and accelerate the creation of annotated training data by expert cardiovascular radiologists or technologists, while limiting the number of necessary manual interactions, and reducing processing time. After automatically classifying blood vessels, bones, and other tissue, the relevant vessels are tracked and organized in a tree-like structure for further visualization.

RESULTS

We conducted a pilot (N = 9) and a clinical study (N = 24) in which we assess the accuracy and required time for our approach to achieve sufficient quality for clinical application, with our current clinically established workflow as the standard of reference. Our approach enabled expert physicians to readily identify all clinically relevant lower extremity arteries, even in problematic cases, with an average sensitivity of 92.9%, and an average specificity and overall accuracy of 99.9%.

CONCLUSIONS

Compared to the clinical workflow in our collaborating hospitals (28:40 ± 7:45 [mm:ss]), our approach (17:24 ± 6:44 [mm:ss]) is on average 11:16 [mm:ss] (39%) faster.

Automated coronary artery tree segmentation in coronary CTA using a multiobjective clustering and toroidal model-guided tracking method

BACKGROUND AND OBJECTIVE

Accurate coronary artery tree segmentation can now be developed to assist radiologists in detecting coronary artery disease. In clinical medicine, the noise, low contrast, and uneven intensity of medical images along with complex shapes and vessel bifurcation structures make coronary artery segmentation challenging. In this work, we propose a multiobjective clustering and toroidal model-guided tracking method that can accurately extract coronary arteries from computed tomography angiography (CTA) imagery.

METHODS

Utilizing integrated noise reduction, candidate region detection, geometric feature extraction, and coronary artery tracking techniques, a new segmentation framework for 3D coronary artery trees is presented. The candidate regions are extracted using a multiobjective clustering method, and the coronary arteries are tracked by a toroidal model-guided tracking method.

RESULTS

The qualitative and quantitative results demonstrate the effectiveness of the presented framework, which achieves better performance than the compared segmentation methods in three widely used evaluation indices: the Dice similarity coefficient (DSC), Jaccard index and Recall across the CTA data. The proposed method can accurately identify the coronary artery tree with a mean DSC of 84%, a Jaccard index of 74%, and a Recall of 93%.

CONCLUSIONS

The proposed segmentation framework effectively segments the coronary tree from the CTA volume, which improves the accuracy of 3D vascular tree segmentation.

Improving Blood Vessel Tortuosity Measurements via Highly Sampled Numerical Integration of the Frenet-Serret Equations

Measures of vascular tortuosity-how curved and twisted a vessel is-are associated with a variety of vascular diseases. Consequently, measurements of vessel tortuosity that are accurate and comparable across modality, resolution, and size are greatly needed. Yet in practice, precise and consistent measurements are problematic-mismeasurements, inability to calculate, or contradictory and inconsistent measurements occur within and across studies. Here, we present a new method of measuring vessel tortuosity that ensures improved accuracy. Our method relies on numerical integration of the Frenet-Serret equations. By reconstructing the three-dimensional vessel coordinates from tortuosity measurements, we explain how to identify and use a minimally-sufficient sampling rate based on vessel radius while avoiding errors associated with oversampling and overfitting. Our work identifies a key failing in current practices of filtering asymptotic measurements and highlights inconsistencies and redundancies between existing tortuosity metrics. We demonstrate our method by applying it to manually constructed vessel phantoms with known measures of tortuousity, and 9,000 vessels from medical image data spanning human cerebral, coronary, and pulmonary vascular trees, and the carotid, abdominal, renal, and iliac arteries.

Visualization of Microvascular Angiogenesis Using Dual-Frequency Contrast-Enhanced Acoustic Angiography: A Review

Cancerous tumor growth is associated with the development of tortuous, chaotic microvasculature, and this aberrant microvascular morphology can act as a biomarker of malignant disease. Acoustic angiography is a contrast-enhanced ultrasound technique that relies on superharmonic imaging to form high-resolution 3-D maps of the microvasculature. To date, acoustic angiography has been performed with dual-element transducers that can achieve high contrast-to-tissue ratio and resolution in pre-clinical small animal models. In this review, we first describe the development of acoustic angiography, including the principle, transducer design, and optimization of superharmonic imaging techniques. We then detail several preclinical applications of this microvascular imaging method, as well as the current and future development of acoustic angiography as a pre-clinical and clinical diagnostic tool.

A Fully Automated Method for Segmenting Arteries and Quantifying Vessel Radii on Magnetic Resonance Angiography Images of Varying Projection Thickness

PURPOSE

Precise quantification of cerebral arteries can help with differentiation and prognostication of cerebrovascular disease. Existing image processing and segmentation algorithms for magnetic resonance angiography (MRA) are limited to the analysis of either 2D maximum intensity projection images or the entire 3D volume. The goal of this study was to develop a fully automated, hybrid 2D-3D method for robust segmentation of arteries and accurate quantification of vessel radii using MRA at varying projection thicknesses.

METHODS

A novel algorithm that employs an adaptive Frangi filter for segmentation of vessels followed by estimation of vessel radii is presented. The method was evaluated on MRA datasets and corresponding manual segmentations from three healthy subjects for various projection thicknesses. In addition, the vessel metrics were computed in four additional subjects. Three synthetically generated angiographic datasets resembling brain vasculature were also evaluated under different noise levels. Dice similarity coefficient, Jaccard Index, F-score, and concordance correlation coefficient were used to measure the segmentation accuracy of manual versus automatic segmentation.

RESULTS

Our new adaptive filter rendered accurate representations of vessels, maintained accurate vessel radii, and corresponded better to manual segmentation at different projection thicknesses than prior methods. Validation with synthetic datasets under low contrast and noisy conditions revealed accurate quantification of vessels without distortions.

CONCLUSION

We have demonstrated a method for automatic segmentation of vascular trees and the subsequent generation of a vessel radii map. This novel technique can be applied to analyze arterial structures in healthy and diseased populations and improve the characterization of vascular integrity.

Vessel Structure Extraction using Constrained Minimal Path Propagation

Minimal path method has been widely recognized as an efficient tool for extracting vascular structures in medical imaging. In a previous paper, a method termed minimal path propagation with backtracking (MPP-BT) was derived to deal with curve-like structures such as vessel centerlines. A robust approach termed CMPP (constrained minimal path propagation) is here proposed to extend this work. The proposed method utilizes another minimal path propagation procedure to extract the complete vessel lumen after the centerlines have been found. Moreover, a process named local MPP-BT is applied to handle structure missing caused by the so-called close loop problems. This approach is fast and unsupervised with only one roughly set start point required in the whole process to get the entire vascular structure. A variety of datasets, including 2D cardiac angiography, 2D retinal images and 3D kidney CT angiography, are used for validation. A quantitative evaluation, together with a comparison to recently reported methods, is performed on retinal images for which a ground truth is available. The proposed method leads to specificity (Sp) and sensitivity (Se) values equal to 0.9750 and 0.6591. This evaluation is also extended to 3D synthetic vascular datasets and shows that the specificity (Sp) and sensitivity (Se) values are higher than 0.99. Parameter setting and computation cost are analyzed in this paper.

Microvascular Ultrasonic Imaging of Angiogenesis Identifies Tumors in a Murine Spontaneous Breast Cancer Model

The purpose of this study is to determine if microvascular tortuosity can be used as an imaging biomarker for the presence of tumor-associated angiogenesis and if imaging this biomarker can be used as a specific and sensitive method of locating solid tumors. Acoustic angiography, an ultrasound-based microvascular imaging technology, was used to visualize angiogenesis development of a spontaneous mouse model of breast cancer (n = 48). A reader study was used to assess visual discrimination between image types, and quantitative methods utilized metrics of tortuosity and spatial clustering for tumor detection. The reader study resulted in an area under the curve of 0.8, while the clustering approach resulted in the best classification with an area under the curve of 0.95. Both the qualitative and quantitative methods produced a correlation between sensitivity and tumor diameter. Imaging of vascular geometry with acoustic angiography provides a robust method for discriminating between tumor and healthy tissue in a mouse model of breast cancer. Multiple methods of analysis have been presented for a wide range of tumor sizes. Application of these techniques to clinical imaging could improve breast cancer diagnosis, as well as improve specificity in assessing cancer in other tissues. The clustering approach may be beneficial for other types of morphological analysis beyond vascular ultrasound images.

Unsupervised Cerebrovascular Segmentation of TOF-MRA Images Based on Deep Neural Network and Hidden Markov Random Field Model

Automated cerebrovascular segmentation of time-of-flight magnetic resonance angiography (TOF-MRA) images is an important technique, which can be used to diagnose abnormalities in the cerebrovascular system, such as vascular stenosis and malformation. Automated cerebrovascular segmentation can direct show the shape, direction and distribution of blood vessels. Although deep neural network (DNN)-based cerebrovascular segmentation methods have shown to yield outstanding performance, they are limited by their dependence on huge training dataset. In this paper, we propose an unsupervised cerebrovascular segmentation method of TOF-MRA images based on DNN and hidden Markov random field (HMRF) model. Our DNN-based cerebrovascular segmentation model is trained by the labeling of HMRF rather than manual annotations. The proposed method was trained and tested using 100 TOF-MRA images. The results were evaluated using the dice similarity coefficient (DSC), which reached a value of 0.79. The trained model achieved better performance than that of the traditional HMRF-based cerebrovascular segmentation method in binary pixel-classification. This paper combines the advantages of both DNN and HMRF to train the model with a not so large amount of the annotations in deep learning, which leads to a more effective cerebrovascular segmentation method.

Reproducibility of an airway tapering measurement in computed tomography with application to bronchiectasis

We propose a pipeline to acquire a scalar tapering measurement from the carina to the most distal point of an individual airway visible on computed tomography (CT). We show the applicability of using tapering measurements on clinically acquired data by quantifying the reproducibility of the tapering measure. We generate a spline from the centerline of an airway to measure the area and arclength at contiguous intervals. The tapering measurement is the gradient of the linear regression between area in log space and arclength. The reproducibility of the measure was assessed by analyzing different radiation doses, voxel sizes, and reconstruction kernel on single timepoint and longitudinal CT scans and by evaluating the effect of airway bifurcations. Using 74 airways from 10 CT scans, we show a statistical difference, p=3.4×10−4, in tapering between healthy airways (n=35) and those affected by bronchiectasis (n=39). The difference between the mean of the two populations is 0.011  mm−1, and the difference between the medians of the two populations was 0.006  mm−1. The tapering measurement retained a 95% confidence interval of ±0.005  mm−1 in a simulated 25 mAs scan and retained a 95% confidence of ±0.005  mm−1 on simulated CTs up to 1.5 times the original voxel size. We have established an estimate of the precision of the tapering measurement and estimated the effect on precision of the simulated voxel size and CT scan dose. We recommend that the scanner calibration be undertaken with the phantoms as described, on the specific CT scanner, radiation dose, and reconstruction algorithm that are to be used in any quantitative studies.

Brain-Wide Shape Reconstruction of a Traced Neuron Using the Convex Image Segmentation Method

Neuronal shape reconstruction is a helpful technique for establishing neuron identity, inferring neuronal connections, mapping neuronal circuits, and so on. Advances in optical imaging techniques have enabled data collection that includes the shape of a neuron across the whole brain, considerably extending the scope of neuronal anatomy. However, such datasets often include many fuzzy neurites and many crossover regions that neurites are closely attached, which make neuronal shape reconstruction more challenging. In this study, we proposed a convex image segmentation model for neuronal shape reconstruction that segments a neurite into cross sections along its traced skeleton. Both the sparse nature of gradient images and the rule that fuzzy neurites usually have a small radius are utilized to improve neuronal shape reconstruction in regions with fuzzy neurites. Because the model is closely related to the traced skeleton point, we can use this relationship for identifying neurite with crossover regions. We demonstrated the performance of our model on various datasets, including those with fuzzy neurites and neurites with crossover regions, and we verified that our model could robustly reconstruct the neuron shape on a brain-wide scale.

Automated Analysis for Retinopathy of Prematurity by Deep Neural Networks

Retinopathy of Prematurity (ROP) is a retinal vasproliferative disorder disease principally observed in infants born prematurely with low birth weight. ROP is an important cause of childhood blindness. Although automatic or semi-automatic diagnosis of ROP has been conducted, most previous studies have focused on "plus" disease, which is indicated by abnormalities of retinal vasculature. Few studies have reported methods for identifying the "stage" of the ROP disease. Deep neural networks have achieved impressive results in many computer vision and medical image analysis problems, raising expectations that it might be a promising tool in the automatic diagnosis of ROP. In this paper, convolutional neural networks with a novel architecture are proposed to recognize the existence and severity of ROP disease per-examination. The severity of ROP is divided into mild and severe cases according to the disease progression. The proposed architecture consists of two sub-networks connected by a feature aggregate operator. The first sub-network is designed to extract high-level features from images of the fundus. These features from different images in an examination are fused by the aggregate operator, then used as the input for the second sub-network to predict its class. A large data set imaged by RetCam 3 is used to train and evaluate the model. The high classification accuracy in the experiment demonstrates the effectiveness of the proposed architecture for recognizing the ROP disease.

Inference of Cerebrovascular Topology With Geodesic Minimum Spanning Trees

A vectorial representation of the vascular network that embodies quantitative features-location, direction, scale, and bifurcations-has many potential cardio- and neuro-vascular applications. We present VTrails, an end-to-end approach to extract geodesic vascular minimum spanning trees from angiographic data by solving a connectivity-optimized anisotropic level-set over a voxel-wise tensor field representing the orientation of the underlying vasculature. Evaluating real and synthetic vascular images, we compare VTrails against the state-of-the-art ridge detectors for tubular structures by assessing the connectedness of the vesselness map and inspecting the synthesized tensor field. The inferred geodesic trees are then quantitatively evaluated within a topologically aware framework, by comparing the proposed method against popular vascular segmentation tool kits on clinical angiographies. VTrails potentials are discussed towards integrating groupwise vascular image analyses. The performance of VTrails demonstrates its versatility and usefulness also for patient-specific applications in interventional neuroradiology and vascular surgery.

Quantification of morphometry and intensity features of intracranial arteries from 3D TOF MRA using the intracranial artery feature extraction (iCafe): A reproducibility study

BACKGROUND

Accurate and reliable vascular features extracted from 3D time-of-flight (TOF) magnetic resonance angiography (MRA) can help evaluate cerebral vascular diseases and conditions. The goal of this study was to evaluate the reproducibility of an intracranial artery feature extraction (iCafe) algorithm for quantitative analysis of intracranial arteries from TOF MRA.

METHODS

Twenty-four patients with known intracranial artery stenosis were recruited and underwent two separate MRA scans within 2 weeks of each other. Each dataset was blinded to associated imaging and clinical data and then processed independently using iCafe. Inter-scan reproducibility analysis was performed on the 24 pairs of scans while intra-/inter-operator reproducibility and stenosis detection were assessed on 8 individual MRA scans. After tracing the vessels visualized on TOF MRA, iCafe was used to automatically extract the locations with stenosis and eight other vascular features. The vascular features included the following six morphometry and two signal intensity features: artery length (total, distal, and proximal), volume, number of branches, average radius of the M1 segment of the middle cerebral artery, and average normalized intensity of all arteries and large vertical arteries. A neuroradiologist independently reviewed the images to identify locations of stenosis for the reference standard. Reproducibility of stenosis detection and vascular features was assessed using Cohen's kappa, the intra-class correlation coefficient (ICC), and within-subject coefficient of variation (CV).

RESULTS

The segment-based sensitivity of iCafe for stenosis detection ranged from 83.3-91.7% while specificity was 97.4%. Kappa values for inter-scan and intra-operator reproducibility were 0.73 and 0.77, respectively. All vascular features demonstrated excellent inter-scan and intra-operator reproducibility (ICC = 0.91-1.00, and CV = 1.21-8.78% for all markers), and good to excellent inter-operator reproducibility (ICC = 0.76-0.99, and CV = 3.27-15.79% for all markers).

CONCLUSION

Intracranial artery features can be reliably quantified from TOF MRA using iCafe to provide both clinical diagnostic assistance and facilitate future investigative quantitative analyses.

Multiple Hidden Markov Model for Pathological Vessel Segmentation

One of the obstacles that prevent the accurate delineation of vessel boundaries is the presence of pathologies, which results in obscure boundaries and vessel-like structures. Targeting this limitation, we present a novel segmentation method based on multiple Hidden Markov Models. This method works with a vessel axis + cross-section model, which constrains the classifier around the vessel. The vessel axis constraint gives our method the potential to be both physiologically accurate and computationally effective. Focusing on pathological vessels, we reap the benefits of the redundant information embedded in multiple vessel-specific features and the good statistical properties coming with Hidden Markov Model, to cover the widest possible spectrum of complex situations. The performance of our method is evaluated on synthetic complex-structured datasets, where we achieve a 91% high overlap ratio. We also validate the proposed method on a real challenging case, segmentation of pathological abdominal arteries. The performance of our method is promising, since our method yields better results than two state-of-the-art methods on both synthetic datasets and real clinical datasets.

Accurate liver vessel segmentation via active contour model with dense vessel candidates

BACKGROUND AND OBJECTIVE

The purpose of this paper is to propose a fully automated liver vessel segmentation algorithm including portal vein and hepatic vein on contrast enhanced CTA images.

METHODS

First, points of a vessel candidate region are extracted from 3-dimensional (3D) CTA image. To generate accurate points, we reduce 3D segmentation problem to 2D problem by generating multiple maximum intensity (MI) images. After the segmentation of MI images, we back-project pixels to the original 3D domain. We call these voxels as vessel candidates (VCs). A large set of MI images can produce very dense and accurate VCs. Finally, for the accurate segmentation of a vessel region, we propose a newly designed active contour model (ACM) that uses the original image, vessel probability map from dense VCs, and the good prior of an initial contour.

RESULTS

We used 55 abdominal CTAs for a parameter study and a quantitative evaluation. We evaluated the performance of the proposed method comparing with other state-of-the-art ACMs for vascular images applied directly to the original data. The result showed that our method successfully segmented vascular structure 25%-122% more accurately than other methods without any extra false positive detection.

CONCLUSION

Our model can generate a smooth and accurate boundary of the vessel object and easily extract thin and weak peripheral branch vessels. The proposed approach can automatically segment a liver vessel without any manual interaction. The detailed result can aid further anatomical studies.

Local variations in material and structural properties characterize murine thoracic aortic aneurysm mechanics

We recently developed an approach to characterize local nonlinear, anisotropic mechanical properties of murine arteries by combining biaxial extension-distension testing, panoramic digital image correlation, and an inverse method based on the principle of virtual power. This experimental-computational approach was illustrated for the normal murine abdominal aorta assuming uniform wall thickness. Here, however, we extend our prior approach by adding an optical coherence tomography (OCT) imaging system that permits local reconstructions of wall thickness. This multimodality approach is then used to characterize spatial variations of material and structural properties in ascending thoracic aortic aneurysms (aTAA) from two genetically modified mouse models (fibrillin-1 and fibulin-4 deficient) and to compare them with those from angiotensin II-infused apolipoprotein E-deficient and wild-type control ascending aortas. Local values of stored elastic energy and biaxial material stiffness, computed from spatial distributions of the best fit material parameters, varied significantly with circumferential position (inner vs. outer curvature, ventral vs. dorsal sides) across genotypes and treatments. Importantly, these data reveal an inverse relationship between material stiffness and wall thickness that underlies a general linear relationship between stiffness and wall stress across aTAAs. OCT images also revealed sites of advanced medial degeneration, which were captured by the inverse material characterization. Quantification of histological data further provided high-resolution local correlations among multiple mechanical metrics and wall microstructure. This is the first time that such structural defects and local properties have been characterized mechanically, which can better inform computational models of aortopathy that seek to predict where dissection or rupture may initiate.

Quantitative analysis of thyroid tumors vascularity: A comparison between 3-D contrast-enhanced ultrasound and 3-D Power Doppler on benign and malignant thyroid nodules

PURPOSE

To perform a comparative quantitative analysis of Power Doppler ultrasound (PDUS) and Contrast-Enhancement ultrasound (CEUS) for the quantification of thyroid nodules vascularity patterns, with the goal of identifying biomarkers correlated with the malignancy of the nodule with both imaging techniques.

METHODS

We propose a novel method to reconstruct the vascular architecture from 3-D PDUS and CEUS images of thyroid nodules, and to automatically extract seven quantitative features related to the morphology and distribution of vascular network. Features include three tortuosity metrics, the number of vascular trees and branches, the vascular volume density, and the main spatial vascularity pattern. Feature extraction was performed on 20 thyroid lesions (ten benign and ten malignant), of which we acquired both PDUS and CEUS. MANOVA (multivariate analysis of variance) was used to differentiate benign and malignant lesions based on the most significant features.

RESULTS

The analysis of the extracted features showed a significant difference between the benign and malignant nodules for both PDUS and CEUS techniques for all the features. Furthermore, by using a linear classifier on the significant features identified by the MANOVA, benign nodules could be entirely separated from the malignant ones.

CONCLUSIONS

Our early results confirm the correlation between the morphology and distribution of blood vessels and the malignancy of the lesion, and also show (at least for the dataset used in this study) a considerable similarity in terms of findings of PDUS and CEUS imaging for thyroid nodules diagnosis and classification.

Cooperative carotid artery centerline extraction in MRI

Centerline extraction of the carotid artery in MRI is important to analyze the artery geometry and to provide input for further processing such as registration and segmentation. The centerline of the artery bifurcation is often extracted by means of two independent minimum cost paths ranging from the common to the internal and the external carotid artery. Often the cost is not well defined at the artery bifurcation, leading to centerline errors. To solve this problem, we developed a method to cooperatively extract both centerlines, where in the cost to extract each centerline, we integrate a constraint region derived from the estimated position of the neighbor centerline. This method avoids that both centerlines follow the same cheapest path after the bifurcation, which is a common error when the paths are extracted independently. We show that this method results in less error compared to extracting them independently: 10 failed centerlines Vs. 3 failures in a data set of 161 arteries with manual annotations. Additionally, we show that the new method improves the non-cooperative approach in 28 cases (p < 0.0001) in a data set of 3,904 arteries.

An unsupervised automatic segmentation algorithm for breast tissue classification of dedicated breast computed tomography images

PURPOSE

To develop and evaluate a new automatic classification algorithm to identify voxels containing skin, vasculature, adipose, and fibroglandular tissue in dedicated breast CT images.

METHODS

The proposed algorithm combines intensity- and region-based segmentation methods with energy minimizing splines and unsupervised data mining approaches for classifying and segmenting the different tissue types. Breast skin segmentation is achieved by a region-growing method which uses constraints from the previously extracted skin centerline to add robustness to the model and to reduce the false positive rate. An energy minimizing active contour model is then used to classify adipose tissue voxels by including gradient flow and region-based features. Finally, blood vessels are separated from fibroglandular tissue by a k-means clustering algorithm based on automatically extracted shape-based features. To evaluate the accuracy of the algorithm, two sets of 15 different patient breast CT scans, each acquired with different breast CT systems and acquisition settings were obtained. Three slices from each scan were manually segmented under the supervision of an experienced breast radiologist and considered the gold standard. Comparisons with manual segmentation were quantified using five similarity metrics: Dice similarity coefficient (DSC), sensitivity, conformity coefficient, and two Hausdorff distance measures. To evaluate the robustness to image noise, the segmentation was repeated after separately adding Gaussian noise with increasing standard deviation (in four steps, from 0.01 to 0.04) to an additional 15 slices from the first dataset. In addition, to evaluate vasculature classification, three different pre- and postcontrast injection patient breast CT images were classified and compared. Finally, DSC was also used for quantitative comparisons with previously proposed approaches for breast CT tissue classification using 10 images from the first dataset.

RESULTS

The algorithm showed a high accuracy in classifying the different tissue types for both breast CT systems, with an average DSC of 95% and 90% for the first and second image dataset, respectively. Furthermore, it demonstrated to be robust to image noise with a robustness to image noise of 85%, 83%, 79%, and 71% for the images corrupted with the four increasing noise levels. Previous methods for breast tissues classification resulted, for the tested dataset, in an average global DSC of 87%, while our approach resulted in a global average DSC of 94.5%.

CONCLUSIONS

The proposed algorithm resulted in accurate and robust breast tissue classification, with no prior training or threshold setting. Potential applications include breast density quantification and tissue pattern characterization (both biomarkers of cancer development), simulation-based radiation dose analysis, and patient data-based phantom design, which could be used for further breast imaging research.

Axis-Guided Vessel Segmentation Using a Self-Constructing Cascade-AdaBoost-SVM Classifier

One major limiting factor that prevents the accurate delineation of vessel boundaries has been the presence of blurred boundaries and vessel-like structures. Overcoming this limitation is exactly what we are concerned about in this paper. We describe a very different segmentation method based on a cascade-AdaBoost-SVM classifier. This classifier works with a vessel axis + cross-section model, which constrains the classifier around the vessel. This has the potential to be both physiologically accurate and computationally effective. To further increase the segmentation accuracy, we organize the AdaBoost classifiers and the Support Vector Machine (SVM) classifiers in a cascade way. And we substitute the AdaBoost classifier with the SVM classifier under special circumstances to overcome the overfitting issue of the AdaBoost classifier. The performance of our method is evaluated on synthetic complex-structured datasets, where we obtain high overlap ratios, around 91%. We also validate the proposed method on one challenging case, segmentation of carotid arteries over real clinical datasets. The performance of our method is promising, since our method yields better results than two state-of-the-art methods on both synthetic datasets and real clinical datasets.

Accurate model-based segmentation of gynecologic brachytherapy catheter collections in MRI-images

The gynecological cancer mortality rate, including cervical, ovarian, vaginal and vulvar cancers, is more than 20,000 annually in the US alone. In many countries, including the US, external-beam radiotherapy followed by high dose rate brachytherapy is the standard-of-care. The superior ability of MR to visualize soft tissue has led to an increase in its usage in planning and delivering brachytherapy treatment. A technical challenge associated with the use of MRI imaging for brachytherapy, in contrast to that of CT imaging, is the visualization of catheters that are used to place radiation sources into cancerous tissue. We describe here a precise, accurate method for achieving catheter segmentation and visualization. The algorithm, with the assistance of manually provided tip locations, performs segmentation using image-features, and is guided by a catheter-specific, estimated mechanical model. A final quality control step removes outliers or conflicting catheter trajectories. The mean Hausdorff error on a 54 patient, 760 catheter reference database was 1.49  mm; 51 of the outliers deviated more than two catheter widths (3.4  mm) from the gold standard, corresponding to catheter identification accuracy of 93% in a Syed-Neblett template. In a multi-user simulation experiment for evaluating RMS precision by simulating varying manually-provided superior tip positions, 3σ maximum errors were 2.44  mm. The average segmentation time for a single catheter was 3 s on a standard PC. The segmentation time, accuracy and precision, are promising indicators of the value of this method for clinical translation of MR-guidance in gynecologic brachytherapy and other catheter-based interventional procedures.