Accurate vessel segmentation with constrained B-snake

Improved SwinUNet with fusion transformer and large kernel convolutional attention for liver and tumor segmentation in CT images

Segmentation of both liver and liver tumors is a critical step in radiation therapy of hepatocellular carcinoma. Despite numerous algorithms have been proposed for organ and tumor delineation, automatic segmentation of livers and liver tumors remains a challenge due to their blurred boundaries and low tissue contrast compared to surrounding organs within CT images. The U-Net-based methods have achieved significant success in this task. However, they often suffer from the limitation that feature extraction lacks relationships, i.e., context, among adjacent areas, thereby leading to uncertainty in segmentation results. To address with this challenge, we incorporate both global-local context and attention into the Swin-UNet. Firstly, we introduce a Swin-neighborhood Fusion Transformer Block (SFTB) to capture both global and local context in an image, enabling us to distinguish instances and their boundaries effectively. Secondly, we design a Large-kernel Convolutional Attention Block (LCAB) with two types of attention to highlight crucial features. Experiments on the LiTS and 3D-IRCADb datasets demonstrate the effectiveness of the proposed method, with dice scores of 0.9559 and 0.9610 for liver segmentation, and 0.7614 and 0.7138 for liver tumor segmentation. The code is available at https://github.com/JennieHJN/image-segmentation/tree/master .

Fibre tracing in biomedical images: An objective comparison between seven algorithms

Obtaining the traces and the characteristics of elongated structures is an important task in computer vision pipelines. In biomedical applications, the analysis of traces of vasculature, nerves or fibres of the extracellular matrix can help characterise processes like angiogenesis or the effect of a certain treatment. This paper presents an objective comparison of six existing methodologies (Edge detection, CT Fire, Scale Space, Twombli, U-Net and Graph Based) and one novel approach called Trace Ridges to trace biomedical images with fibre-like structures. Trace Ridges is a fully automatic and fast algorithm that combines a series of image-processing algorithms including filtering, watershed transform and edge detection to obtain an accurate delineation of the fibre-like structures in a rapid time. To compare the algorithms, four biomedical data sets with vastly distinctive characteristics were selected. Ground truth was obtained by manual delineation of the fibre-like structures. Three pre-processing filtering options were used as a first step: no filtering, Gaussian low-pass and DnCnn, a deep-learning filtering. Three distance error metrics (total, average and maximum distance from the obtained traces to the ground truth) and processing time were calculated. It was observed that no single algorithm outperformed the others in all metrics. For the total distance error, which was considered the most significative, Trace Ridges ranked first, followed by Graph Based, U-Net, Twombli, Scale Space, CT Fire and Edge Detection. In terms of speed, Trace Ridges ranked second, only slightly slower than Edge Detection. Code is freely available at github.com/youssefarafat/Trace_Ridges.

Compensation of small data with large filters for accurate liver vessel segmentation from contrast-enhanced CT images

BACKGROUND

Segmenting liver vessels from contrast-enhanced computed tomography images is essential for diagnosing liver diseases, planning surgeries and delivering radiotherapy. Nevertheless, identifying vessels is a challenging task due to the tiny cross-sectional areas occupied by vessels, which has posed great challenges for vessel segmentation, such as limited features to be learned and difficult to construct high-quality as well as large-volume data.

METHODS

We present an approach that only requires a few labeled vessels but delivers significantly improved results. Our model starts with vessel enhancement by fading out liver intensity and generates candidate vessels by a classifier fed with a large number of image filters. Afterwards, the initial segmentation is refined using Markov random fields.

RESULTS

In experiments on the well-known dataset 3D-IRCADb, the averaged Dice coefficient is lifted to 0.63, and the mean sensitivity is increased to 0.71. These results are significantly better than those obtained from existing machine-learning approaches and comparable to those generated from deep-learning models.

CONCLUSION

Sophisticated integration of a large number of filters is able to pinpoint effective features from liver images that are sufficient to distinguish vessels from other liver tissues under a scarcity of large-volume labeled data. The study can shed light on medical image segmentation, especially for those without sufficient data.

Suitability of DNN-based vessel segmentation for SIRT planning

PURPOSE

The segmentation of the hepatic arteries (HA) is essential for state-of-the-art pre-interventional planning of selective internal radiation therapy (SIRT), a treatment option for malignant tumors in the liver. In SIRT a catheter is placed through the aorta into the tumor-feeding hepatic arteries, injecting small beads filled with radiation emitting material for local radioembolization. In this study, we evaluate the suitability of a deep neural network (DNN) based vessel segmentation for SIRT planning.

METHODS

We applied our DNN-based HA segmentation on 36 contrast-enhanced computed tomography (CT) scans from the arterial contrast agent phase and rated its segmentation quality as well as the overall image quality. Additionally, we applied a traditional machine learning algorithm for HA segmentation as comparison to our deep learning (DL) approach. Moreover, we assessed by expert ratings whether the produced HA segmentations can be used for SIRT planning.

RESULTS

The DL approach outperformed the traditional machine learning algorithm. The DL segmentation can be used for SIRT planning in [Formula: see text] of the cases, while the reference segmentations, which were manually created by experienced radiographers, are sufficient in [Formula: see text]. Seven DL cases cannot be used for SIRT planning while the corresponding reference segmentations are sufficient. However, there are two DL segmentations usable for SIRT, where the reference segmentations for the same cases were rated as insufficient.

CONCLUSIONS

HA segmentation is a difficult and time-consuming task. DL-based methods have the potential to support and accelerate the pre-interventional planning of SIRT therapy.

Robust Vascular Segmentation for Raw Complex Images of Laser Speckle Contrast Based on Weakly Supervised Learning

Laser speckle contrast imaging (LSCI) is widely used for in vivo real-time detection and analysis of local blood flow microcirculation due to its non-invasive ability and excellent spatial and temporal resolution. However, vascular segmentation of LSCI images still faces a lot of difficulties due to numerous specific noises caused by the complexity of blood microcirculation's structure and irregular vascular aberrations in diseased regions. In addition, the difficulties of LSCI image data annotation have hindered the application of deep learning methods based on supervised learning in the field of LSCI image vascular segmentation. To tackle these difficulties, we propose a robust weakly supervised learning method, which selects the threshold combinations and processing flows instead of labor-intensive annotation work to construct the ground truth of the dataset, and design a deep neural network, FURNet, based on UNet++ and ResNeXt. The model obtained from training achieves high-quality vascular segmentation and captures multi-scene vascular features on both constructed and unknown datasets with good generalization. Furthermore, we intravital verified the availability of this method on a tumor before and after embolization treatment. This work provides a new approach for realizing LSCI vascular segmentation and also makes a new application-level advance in the field of artificial intelligence-assisted disease diagnosis.

Automatic coronary artery segmentation of CCTA images using UNet with a local contextual transformer

Coronary artery segmentation is an essential procedure in the computer-aided diagnosis of coronary artery disease. It aims to identify and segment the regions of interest in the coronary circulation for further processing and diagnosis. Currently, automatic segmentation of coronary arteries is often unreliable because of their small size and poor distribution of contrast medium, as well as the problems that lead to over-segmentation or omission. To improve the performance of convolutional-neural-network (CNN) based coronary artery segmentation, we propose a novel automatic method, DR-LCT-UNet, with two innovative components: the Dense Residual (DR) module and the Local Contextual Transformer (LCT) module. The DR module aims to preserve unobtrusive features through dense residual connections, while the LCT module is an improved Transformer that focuses on local contextual information, so that coronary artery-related information can be better exploited. The LCT and DR modules are effectively integrated into the skip connections and encoder-decoder of the 3D segmentation network, respectively. Experiments on our CorArtTS2020 dataset show that the dice similarity coefficient (DSC), Recall, and Precision of the proposed method reached 85.8%, 86.3% and 85.8%, respectively, outperforming 3D-UNet (taken as the reference among the 6 other chosen comparison methods), by 2.1%, 1.9%, and 2.1%.

Quantitative analysis validation for sclerotherapy treatment of lower limb telangiectasias

BACKGROUND

The evaluation of sclerotherapy efficacy for lower limb telangiectasias, which is the standard treatment for such condition, is commonly assisted by scores based on before and after pictures. This method is marked by its subjectivity, which impairs the precision of studies on the subject, making it unfeasible to evaluate and compare different interventions. We hypothesize that a quantitative method for evaluating the effectiveness of sclerotherapy for lower limb telangiectasias may present more reproducible results. Reliable measurement methods and new technologies may become part of the clinical practice in the near future.

METHODS

Before and after treatment photographs were analyzed using a quantitative method and compared with a validated qualitative method based on improvement scores. Reliability analysis of the methods was performed, applying the intraclass correlation coefficient (ICC) and kappa coefficient with quadratic weights (Fleiss Cohen), for analysis of inter-examiner and intra-examiner agreement in both evaluation methods. Convergent validity was evaluated by applying the Spearman test. To assess the applicability of the quantitative scale, the Mann-Whitney test was used.

RESULTS

A better agreement between examiners is shown for the quantitative scale, with a mean kappa of .3986 (.251-.511) for qualitative analysis and a mean kappa of .788 (.655-.918) for quantitative analysis (P < .001 for all examiners). Convergent validity was achieved by correlation coefficients of .572 to .905 (P < .001). The quantitative scale results obtained between the specialists with different degrees of experience did not show statistical difference (seniors: 0.71 [-0.48/1.00] × juniors: 0.73 [-0.34/1.00]; P = .221).

CONCLUSIONS

Convergent validity between both analyses has been achieved, but quantitative analysis has been shown to be more reliable and can be applied by professionals of any degree of experience. The validation of quantitative analysis is a major milestone for the development of new technology and automated, reliable, applications.

RMAU-Net: Residual Multi-Scale Attention U-Net For liver and tumor segmentation in CT images

Liver cancer is one of the leading causes of cancer-related deaths worldwide. Automatic liver and tumor segmentation are of great value in clinical practice as they can reduce surgeons' workload and increase the probability of success in surgery. Liver and tumor segmentation is a challenging task because of the different sizes, shapes, blurred boundaries of livers and lesions, and low-intensity contrast between organs within patients. To address the problem of fuzzy livers and small tumors, we propose a novel Residual Multi-scale Attention U-Net (RMAU-Net) for liver and tumor segmentation by introducing two modules, i.e., Res-SE-Block and MAB. The Res-SE-Block can mitigate the problem of gradient disappearance by residual connection and enhance the quality of representations by explicitly modeling the interdependencies and feature recalibration between the channels of features. The MAB can exploit rich multi-scale feature information and capture inter-channel and inter-spatial relationships of features simultaneously. In addition, a hybrid loss function, that combines focal loss and dice loss, is designed to improve segmentation accuracy and speed up convergence. We evaluated the proposed method on two publicly available datasets, i.e., LiTS and 3D-IRCADb. Our proposed method achieved better performance than the other state-of-the-art methods, with dice scores of 0.9552 and 0.9697 for LiTS and 3D-IRCABb liver segmentation, and dice scores of 0.7616 and 0.8307 for LiTS and 3D-IRCABb liver tumor segmentation.

Hepatic Vein and Arterial Vessel Segmentation in Liver Tumor Patients

Preoperative observation of liver status in patients with liver tumors by abdominal Computed Tomography (CT) imaging is one of the essential references for formulating surgical plans. Preoperative vessel segmentation in the patient's liver region has become an increasingly important and challenging problem. Almost all existing methods first segment arterial and venous vessels on CT in the arterial and venous phases, respectively. Then, the two are directly registered to complete the reconstruction of the vascular system, ignoring the displacement and deformation of blood vessels caused by changes in body position and respiration in the two phases. We propose an unsupervised domain-adaptive two-stage vessel segmentation framework for simultaneous fine segmentation of arterial and venous vessels on venous phase CT. Specifically, we first achieve domain adaptation for arterial and venous phase CT using a modified cycle-consistent adversarial network. The newly added discriminator can improve the ability to generate and discriminate tiny blood vessels, making the domain-adaptive network more robust. The second-stage supervised training of arterial vessels was then performed on the translated arterial phase CT. In this process, we propose an orthogonal depth projection loss function to enhance the representation ability of the 3D U-shape segmentation network for the geometric information of the vessel model. The segmented venous vessels were also performed on venous phase CT in the second stage. Finally, we invited professional doctors to annotate arterial and venous vessels on the venous phase CT of the test set. The experimental results show that the segmentation accuracy of arterial and venous vessels on venous phase CT is 0.8454 and 0.8087, respectively. Our proposed framework can simultaneously achieve supervised segmentation of venous vessels and unsupervised segmentation of arterial vessels on venous phase CT. Our approach can be extended to other fields of medical segmentation, such as unsupervised domain adaptive segmentation of liver tumors at different CT phases, to facilitate the development of the community.

Simultaneous vessel segmentation and unenhanced prediction using self-supervised dual-task learning in 3D CTA (SVSUP)

BACKGROUND AND OBJECTIVE

The vessel segmentation in CT angiography (CTA) provides an important basis for automatic diagnosis and hemodynamics analysis. Virtual unenhanced (VU) CT images obtained by dual-energy CT can assist clinical diagnosis and reduce radiation dose by obviating true unenhanced imaging (UECT). However, accurate segmentation of all vessels in the head-neck CTA (HNCTA) remains a challenge, and VU images are currently not available from conventional single-energy CT imaging.

METHODS

In this paper, we proposed a self-supervised dual-task deep learning strategy to fully automatically segment all vessels and predict unenhanced CT images from single-energy HNCTA based on a developed iterative residual-sharing scheme. The underlying idea was to use the correlation between the two tasks to improve task performance while avoiding manual annotation for model training.

RESULTS

The feasibility of the strategy was verified using the data of 24 patients. For vessel segmentation task, the proposed model achieves a significantly higher average Dice coefficient (84.83%, P-values 10^-3 in paired t-test) than the state-of-the-art segmentation model, vanilla VNet (78.94%), and several popular 3D vessel segmentation models, including Hessian-matrix based filter (62.59%), optically-oriented flux (66.33%), spherical flux model (66.91%), and deep vessel net (66.47%). For the unenhanced prediction task, the average ROI-based error compared to the UECT in the artery tissue is 6.1±4.5 HU, similar to previously reported 6.4±5.1 HU for VU reconstruction.

CONCLUSIONS

Results show that the proposed dual-task framework can effectively improve the accuracy of vessel segmentation in HNCTA, and it is feasible to predict the unenhanced image from single-energy CTA, providing a potential new approach for radiation dose saving. Moreover, to our best knowledge, this is the first reported annotation-free deep learning-based full-image vessel segmentation for HNCTA.

Accelerated vascular aging: Ethnic differences in basilar artery length and diameter, and its association with cardiovascular risk factors and cerebral small vessel disease

Background and aims

Risk of stroke and dementia is markedly higher in people of South Asian and African Caribbean descent than white Europeans in the UK. This is unexplained by cardiovascular risk factors (CVRF). We hypothesized this might indicate accelerated early vascular aging (EVA) and that EVA might account for stronger associations between cerebral large artery characteristics and markers of small vessel disease.

Methods

360 participants in a tri-ethnic population-based study (120 per ethnic group) underwent cerebral and vertebral MRI. Length and median diameter of the basilar artery (BA) were derived from Time of Flight images, while white matter hyperintensities (WMH) volumes were obtained from T1 and FLAIR images. Associations between BA characteristics and CVRF were assessed using multivariable linear regression. Partial correlation coefficients between WMH load and BA characteristics were calculated after adjustment for CVRF and other potential confounders.

Results

BA diameter was strongly associated with age in South Asians (+11.3 μm/year 95% CI = [3.05; 19.62]; p = 0.008), with unconvincing relationships in African Caribbeans (3.4 μm/year [-5.26, 12.12]; p = 0.436) or Europeans (2.6 μm/year [-5.75, 10.87]; p = 0.543). BA length was associated with age in South Asians (+0.34 mm/year [0.02; 0.65]; p = 0.037) and African Caribbeans (+0.39 mm/year [0.12; 0.65]; p = 0.005) but not Europeans (+0.08 mm/year [-0.26; 0.41]; p = 0.653). BA diameter (rho = 0.210; p = 0.022) and length (rho = 0.261; p = 0.004) were associated with frontal WMH load in South Asians (persisting after multivariable adjustment for CVRF).

Conclusions

Compared with Europeans, the basilar artery undergoes more accelerated EVA in South Asians and in African Caribbeans, albeit to a lesser extent. Such EVA may contribute to the higher burden of CSVD observed in South Asians and excess risk of stroke, vascular cognitive impairment and dementia observed in these ethnic groups.

Deep Learning Based Real-Time Semantic Segmentation of Cerebral Vessels and Cranial Nerves in Microvascular Decompression Scenes

Automatic extraction of cerebral vessels and cranial nerves has important clinical value in the treatment of trigeminal neuralgia (TGN) and hemifacial spasm (HFS). However, because of the great similarity between different cerebral vessels and between different cranial nerves, it is challenging to segment cerebral vessels and cranial nerves in real time on the basis of true-color microvascular decompression (MVD) images. In this paper, we propose a lightweight, fast semantic segmentation Microvascular Decompression Network (MVDNet) for MVD scenarios which achieves a good trade-off between segmentation accuracy and speed. Specifically, we designed a Light Asymmetric Bottleneck (LAB) module in the encoder to encode context features. A Feature Fusion Module (FFM) was introduced into the decoder to effectively combine high-level semantic features and underlying spatial details. The proposed network has no pretrained model, fewer parameters, and a fast inference speed. Specifically, MVDNet achieved 76.59% mIoU on the MVD test set, has 0.72 M parameters, and has a 137 FPS speed using a single GTX 2080Ti card.

Multi-perspective label based deep learning framework for cerebral vasculature segmentation in whole-brain fluorescence images

The popularity of fluorescent labelling and mesoscopic optical imaging techniques enable the acquisition of whole mammalian brain vasculature images at capillary resolution. Segmentation of the cerebrovascular network is essential for analyzing the cerebrovascular structure and revealing the pathogenesis of brain diseases. Existing deep learning methods use a single type of annotated labels with the same pixel weight to train the neural network and segment vessels. Due to the variation in the shape, density and brightness of vessels in whole-brain fluorescence images, it is difficult for a neural network trained with a single type of label to segment all vessels accurately. To address this problem, we proposed a deep learning cerebral vasculature segmentation framework based on multi-perspective labels. First, the pixels in the central region of thick vessels and the skeleton region of vessels were extracted separately using morphological operations based on the binary annotated labels to generate two different labels. Then, we designed a three-stage 3D convolutional neural network containing three sub-networks, namely thick-vessel enhancement network, vessel skeleton enhancement network and multi-channel fusion segmentation network. The first two sub-networks were trained by the two labels generated in the previous step, respectively, and pre-segmented the vessels. The third sub-network was responsible for fusing the pre-segmented results to precisely segment the vessels. We validated our method on two mouse cerebral vascular datasets generated by different fluorescence imaging modalities. The results showed that our method outperforms the state-of-the-art methods, and the proposed method can be applied to segment the vasculature on large-scale volumes.

Unsupervised Three-Dimensional Tubular Structure Segmentation via Filter Combination

Tubular structure enhancement plays an utmost role in medical image segmentation as a pre-processing technique. In this work, an unsupervised 3D tubular structure segmentation technique is developed, which is mainly inspired by the idea of filter combination. Three well-known vessel filters, Frangi’s filter, the modified Frangi’s filter and the Multiscale Fractional Anisotropic Tensor (MFAT) filter, separately enhance the original images. Next, the enhanced images obtained using three different filters are combined. Different categories of vessel filters have the ability of complementarity, which is the main motivation of combining these three advanced filters. The combination of them ensures a high diversity of the enhancing results. Weighted mean and median ranking methods are used to conduct the operation of filter combination. Based on the optimized weights for all the three individual filters, fuzzy C-means method is then applied to segment the tubular structures. The proposed technique is tested on the public DRIVE and STARE datasets, the public synthetic vascular models (2011 and 2013 VascuSynth Sample), and real-patient Coronary Computed Tomography Angiography (CCTA) datasets. Experimental results demonstrate that the proposed technique outperforms the state-of-the-art filter combination-based segmentation methods. Moreover, our proposed method is able to yield better tubular structure segmentation results than that of each individual filter, which exhibits the superiority of the proposed method. In conclusion, the proposed method can be further used to facilitate vessel segmentation in medical practice.

Automatic multi-plaque tracking and segmentation in ultrasonic videos

Carotid plaque tracking and segmentation in ultrasound videos is the premise for subsequent plaque property evaluation and treatment plan development. However, the task is quite challenging, as it needs to address the problems of poor image quality, plaque shape variations among frames, the existence of multiple plaques, etc. To overcome these challenges, we propose a new automatic multi-plaque tracking and segmentation (AMPTS) framework. AMPTS consists of three modules. The first module is a multi-object detector, in which a Dual Attention U-Net is proposed to detect multiple plaques and vessels simultaneously. The second module is a set of single-object trackers that can utilize the previous tracking results efficiently and achieve stable tracking of the current target by using channel attention and a ranking strategy. To make the first module and the second module work together, a parallel tracking module based on a simplified 'tracking-by-detection' mechanism is proposed to solve the challenge of tracking object variation. Extensive experiments are conducted to compare the proposed method with several state-of-the-art deep learning based methods. The experimental results demonstrate that the proposed method has high accuracy and generalizability with a Dice similarity coefficient of 0.83 which is 0.16, 0.06 and 0.27 greater than MAST (Lai et al., 2020), Track R-CNN (Voigtlaender et al., 2019) and VSD (Yang et al., 2019) respectively and has made significant improvements on seven other indicators. In the additional Testing set 2, our method achieved a Dice similarity coefficient of 0.80, an accuracy of 0.79, a precision of 0.91, a Recall 0.70, a F1 score of 0.79, an AP@0.5 of 0.92, an AP@0.7 of 0.74, and an expected average overlap of 0.79. Numerous ablation studies suggest the effectiveness of each proposed component and the great potential for multiple carotid plaques tracking and segmentation in clinical practice.

Living Donor-Recipient Pair Matching for Liver Transplant via Ternary Tree Representation With Cascade Incremental Learning

Visual understanding of liver vessels anatomy between the living donor-recipient (LDR) pair can assist surgeons to optimize transplant planning by avoiding non-targeted arteries which can cause severe complications. We propose to visually analyze the anatomical variants of the liver vessels anatomy to maximize similarity for finding a suitable Living Donor-Recipient (LDR) pair. Liver vessels are segmented from computed tomography angiography (CTA) volumes by employing a cascade incremental learning (CIL) model. Our CIL architecture is able to find optimal solutions, which we use to update the model with liver vessel CTA images. A novel ternary tree based algorithm is proposed to map all the possible liver vessel variants into their respective tree topologies. The tree topologies of the recipient's and donor's liver vessels are then used for an appropriate matching. The proposed algorithm utilizes a set of defined vessel tree variants which are updated to maintain the maximum matching options by leveraging the accurate segmentation results of the vessels derived from the incremental learning ability of the CIL. We introduce a novel concept of in-order digital string based comparison to match the geometry of two anatomically varied trees. Experiments through visual illustrations and quantitative analysis demonstrated the effectiveness of our approach compared to state-of-the-art.

Computational Methods for Liver Vessel Segmentation in Medical Imaging: A Review

The segmentation of liver blood vessels is of major importance as it is essential for formulating diagnoses, planning and delivering treatments, as well as evaluating the results of clinical procedures. Different imaging techniques are available for application in clinical practice, so the segmentation methods should take into account the characteristics of the imaging technique. Based on the literature, this review paper presents the most advanced and effective methods of liver vessel segmentation, as well as their performance according to the metrics used. This paper includes results available for four imaging methods, namely: computed tomography (CT), computed tomography angiography (CTA), magnetic resonance (MR), and ultrasonography (USG). The publicly available datasets used in research are also presented. This paper may help researchers gain better insight into the available materials and methods, making it easier to develop new, more effective solutions, as well as to improve existing approaches. This article analyzes in detail various segmentation methods, which can be divided into three groups: active contours, tracking-based, and machine learning techniques. For each group of methods, their theoretical and practical characteristics are discussed, and the pros and cons are highlighted. The most advanced and promising approaches are also suggested. However, we conclude that liver vasculature segmentation is still an open problem, because of the various deficiencies and constraints researchers need to address and try to eliminate from the solutions used.

A comparative analysis framework of 3T and 7T TOF-MRA based on automated cerebrovascular segmentation

PURPOSE

High field strength 3T and 7T Time-Of-Flight Magnetic Resonance Angiography (TOF- MRA) achieves better visualization of intracranial vessels, so it attracts much attention. However, quantitative comparison between 3T and 7T MRA is lacking in the aspects of image quality and the practical application of cerebrovascular diseases.

METHODS

In this paper, a quantitative framework of 3T and 7T TOF-MRA comparison is proposed, which contains two steps including the automated cerebrovascular segmentation and statistical analysis. Firstly, the whole vascular structures on both 3T and 7T TOF-MRA images are segmented automatically, especially those small blood vessels in 7T MRA. The skeleton extraction-based automatic seed point detection is implemented to ensure the segmented vascular structure complete and precise. Secondly, the statistical analysis of the differences between 3T and 7T MRA is carried out in the aspects of image quality and the characteristics of some important vessels. The objects of statistical analysis are achieved and analyzed automatically without needing the time- consuming human beings' participation, therefore, it is efficient and objective.

RESULTS

The comparison experiments on seven pairs of 3T and 7T TOF MRA images validated that about image quality, the contrast-to-noise ratio of 7T MRA was about 4.53 ± 0.95 times as much as that of 3T MRA. About the cerebrovascular information, small vessels were more abundant in 7T MRA compared with 3T MRA (branches number: 462.0 ± 58.5 vs 393.1 ± 63.3).

CONCLUSIONS

The proposed framework can segment the whole cerebrovascular structure automatically and compare TOF-MRA with different field strengths objectively and quantitatively. It is helpful for clinical cerebrovascular disease, especially cerebral small vessel diseases.

Fully Automated Integrated Segmentation of Carotid Artery Ultrasound Images Using DBSCAN and Affinity Propagation

Purpose

B-mode ultrasound images are used in identifying the presence of fat deposit if any in carotid artery. The intima media, lumen, bifurcation boundary is detected by the echogenic characteristics embedded in the carotid artery.

Methods

A fully automatic self-learning based segmentation is proposed by extracting the edges by a modified affinity propagation, which are given as inputs to the Density Based Spatial Clustering of Applications with Noise (DBSCAN) for super pixel segmentation. The segmented results are analyzed with Gradient Vector Flow (GVF) snake model and Particle Swarm Optimization (PSO) clustering based segmentation using various performance measures.

Results

The proposed parameter free, fully automatic segmentation method combining Affinity propagation and DBSCAN are evaluated for a database of 361 images and gives reinforced results in the longitudinal B-mode ultrasound images. The proposed approach gives an improved accuracy of 12% increase when compared with the manual segmentation and 15% compared with segmentation by affinity propagation and DBSCAN when performed individually. The average Root Mean Square Error (RMSE) is 110 ± 44 µm.

Conclusion

Extracted edge points are used for clustering in a fully automated carotid artery segmentation approach.

CS2-Net: Deep learning segmentation of curvilinear structures in medical imaging

Automated detection of curvilinear structures, e.g., blood vessels or nerve fibres, from medical and biomedical images is a crucial early step in automatic image interpretation associated to the management of many diseases. Precise measurement of the morphological changes of these curvilinear organ structures informs clinicians for understanding the mechanism, diagnosis, and treatment of e.g. cardiovascular, kidney, eye, lung, and neurological conditions. In this work, we propose a generic and unified convolution neural network for the segmentation of curvilinear structures and illustrate in several 2D/3D medical imaging modalities. We introduce a new curvilinear structure segmentation network (CS²-Net), which includes a self-attention mechanism in the encoder and decoder to learn rich hierarchical representations of curvilinear structures. Two types of attention modules - spatial attention and channel attention - are utilized to enhance the inter-class discrimination and intra-class responsiveness, to further integrate local features with their global dependencies and normalization, adaptively. Furthermore, to facilitate the segmentation of curvilinear structures in medical images, we employ a 1×3 and a 3×1 convolutional kernel to capture boundary features. Besides, we extend the 2D attention mechanism to 3D to enhance the network's ability to aggregate depth information across different layers/slices. The proposed curvilinear structure segmentation network is thoroughly validated using both 2D and 3D images across six different imaging modalities. Experimental results across nine datasets show the proposed method generally outperforms other state-of-the-art algorithms in various metrics.

Segmentation of the placenta and its vascular tree in Doppler ultrasound for fetal surgery planning

PURPOSE

Twin-to-twin transfusion syndrome (TTTS) is a serious condition that occurs in about 10-15% of monochorionic twin pregnancies. In most instances, the blood flow is unevenly distributed throughout the placenta anastomoses leading to the death of both fetuses if no surgical procedure is performed. Fetoscopic laser coagulation is the optimal therapy to considerably improve co-twin prognosis by clogging the abnormal anastomoses. Notwithstanding progress in recent years, TTTS surgery is highly risky. Computer-assisted planning of the intervention can thus improve the outcome.

METHODS

In this work, we implement a GPU-accelerated random walker (RW) algorithm to detect the placenta, both umbilical cord insertions and the placental vasculature from Doppler ultrasound (US). Placenta and background seeds are manually initialized in 10-20 slices (out of 245). Vessels are automatically initialized in the same slices by means of Otsu thresholding. The RW finds the boundaries of the placenta and reconstructs the vasculature.

RESULTS

We evaluate our semiautomatic method in 5 monochorionic and 24 singleton pregnancies. Although satisfactory performance is achieved on placenta segmentation (Dice ≥ 84.0%), some vascular connections are still neglected due to the presence of US reverberation artifacts (Dice ≥ 56.9%). We also compared inter-user variability and obtained Dice coefficients of ≥ 76.8% and ≥ 97.42% for placenta and vasculature, respectively. After a 3-min manual initialization, our GPU approach speeds the computation 10.6 times compared to the CPU.

CONCLUSIONS

Our semiautomatic method provides a near real-time user experience and requires short training without compromising the segmentation accuracy. A powerful approach is thus presented to rapidly plan the fetoscope insertion point ahead of TTTS surgery.

Accelerating Chan-Vese model with cross-modality guided contrast enhancement for liver segmentation

Accurate and fast liver segmentation remains a challenging and important task for clinicians. Segmentation algorithms are slow and inaccurate due to noise and low quality images in computed tomography (CT) abdominal scans. Chan-Vese is an active contour based powerful and flexible method for image segmentation due to superior noise robustness. However, it is quite slow due to time-consuming partial differential equations, especially for large medical datasets. This can pose a problem for a real-time implementation of liver segmentation and hence, an efficient parallel implementation is highly desirable. Another important aspect is the contrast of CT liver images. Liver slices are sometimes very low in contrast which reduces the overall quality of liver segmentation. Hence, we implement cross-modality guided liver contrast enhancement as a pre-processing step to liver segmentation. GPU implementation of Chan-Vese improves average speedup by 99.811 (± 7.65) times and 14.647 (± 1.155) times with and without enhancement respectively in comparison with the CPU. Average dice, sensitivity and accuracy of liver segmentation are 0.656, 0.816 and 0.822 respectively on the original liver images and 0.877, 0.964 and 0.956 respectively on the enhanced liver images improving the overall quality of liver segmentation.

Using a distance map and an active contour model to segment the carotid artery boundary from the lumen contour in proton density weighted magnetic resonance images

Segmentation methods have assumed an important role in image-based diagnosis of several cardiovascular diseases. Particularly, the segmentation of the boundary of the carotid artery is demanded in the detection and characterization of atherosclerosis and assessment of the disease progression. In this article, a fully automatic approach for the segmentation of the carotid artery boundary in Proton Density Weighted Magnetic Resonance Images is presented. The approach relies on the expansion of the lumen contour based on a distance map built using the gray-weighted distance relative to the center of the identified lumen region in the image under analysis. Then, a Snake model with a modified weighted external energy based on the combination of a balloon force along with a Gradient Vector Flow-based external energy is applied to the expanded contour towards the correct boundary of the carotid artery. The average values of the Dice coefficient, Polyline distance, mean contour distance and centroid distance found in the segmentation of 139 carotid arteries were 0.83 ± 0.11, 2.70 ± 1.69 pixels, 2.79 ± 1.89 pixels and 3.44 ± 2.82 pixels, respectively. The segmentation results of the proposed approach were also compared against the ones obtained by related approaches found in the literature, which confirmed the outstanding performance of the new approach. Additionally, the proposed weighted external energy for the Snake model was shown to be also robust to carotid arteries with large thickness and weak boundary image edges.

A statistical weighted sparse-based local lung motion modelling approach for model-driven lung biopsy

PURPOSE

Lung biopsy is currently the most effective procedure for cancer diagnosis. However, respiration-induced location uncertainty presents a challenge in precise lung biopsy. To reduce the medical image requirements for motion modelling, in this study, local lung motion information in the region of interest (ROI) is extracted from whole chest computed tomography (CT) and CT-fluoroscopy scans to predict the motion of potentially cancerous tissue and important vessels during the model-driven lung biopsy process.

METHODS

The motion prior of the ROI was generated via a sparse linear combination of a subset of motion information from a respiratory motion repository, and a weighted sparse-based statistical model was used to preserve the local respiratory motion details. We also employed a motion prior-based registration method to improve the motion estimation accuracy in the ROI and designed adaptive variable coefficients to interactively weigh the relative influence of the prior knowledge and image intensity information during the registration process.

RESULTS

The proposed method was applied to ten test subjects for the estimation of the respiratory motion field. The quantitative analysis resulted in a mean target registration error of 1.5 (0.8) mm and an average symmetric surface distance of 1.4 (0.6) mm.

CONCLUSIONS

The proposed method shows remarkable advantages over traditional methods in preserving local motion details and reducing the estimation error in the ROI. These results also provide a benchmark for lung respiratory motion modelling in the literature.

Statistical modeling and knowledge-based segmentation of cerebral artery based on TOF-MRA and MR-T1

BACKGROUND AND OBJECTIVE

For cerebrovascular segmentation from time-of-flight (TOF) magnetic resonance angiography (MRA), the focused issues are segmentation accuracy, vascular network coverage ratio, and cerebral artery and vein (CA/CV) separation. Therefore, cerebral artery segmentation is a challenging work, while a complete solution is lacking so far.

METHODS

The preprocessing of skull-stripping and Hessian-based feature extraction is first implemented to acquire an indirect prior knowledge of vascular distribution and shape. Then, a novel intensity- and shape-based Markov statistical modeling is proposed for complete cerebrovascular segmentation, where our low-level process employs a Gaussian mixture model to fit the intensity histogram of the skull-stripped TOF-MRA data, while our high-level process employs the vascular shape prior to construct the energy function. To regularize the individual data processes, Markov regularization parameter is automatically estimated by using a machine-learning algorithm. Further, cerebral artery and vein (CA/CV) separation is explored with a series of morphological logic operations, which are based on a direct priori knowledge on the relationship of arteriovenous topology and brain tissues in between TOF-MRA and MR-T1.

RESULTS

We employed 109 sets of public datasets from MIDAS for qualitative and quantitative assessment. The Dice similarity coefficient, false negative rate (FNR), and false positive rate (FPR) of 0.933, 0.158, and 0.091% on average, as well as CA/CV separation results with the agreement, FNR, and FPR of 0.976, 0.041, and 0.022 on average. For clinical visual assessment, our methods can segment various sizes of the vessel in different contrast region, especially performs better on vessels of small size in low contrast region.

CONCLUSION

Our methods obtained satisfying results in visual and quantitative evaluation. The proposed method is capable of accurate cerebrovascular segmentation and efficient CA/CV separation. Further, it can stimulate valuable clinical applications on the computer-assisted cerebrovascular intervention according to the neurosurgeon's recommendation.

Three-dimensional extension of blood vessel network by combining multiple ultrasound volumes from different directions

We have previously proposed the use of acoustic radiation force in blood vessels for therapeutic application of ultrasound. For this purpose, we have developed a blood vessel network reconstruction algorithm to fuse between B-mode and Doppler-mode volumes. However, a size of ultrasound volume was insufficient to recognize the network for treatment. Therefore, using multiple ultrasound volumes, we propose a method to extend a network with neighbor networks. First, an ultrasound volume was analyzed to extract tree-structure including the nodes and the edges. Then we configured an extension method between two tree-structures, which performs the insertion of nodes in a source tree to a target tree. Next, similarity between two networks were evaluated by introducing edge lengths in the network and the edit distance. By analyzing in vivo blood vessel of porcine liver, we confirmed that the construction of the network was reliable according to the extension with the similarity of 60% compared with CT data. We confirmed that the proposed method is effective for reconstructing blood vessel network.

Inter/intra-frame constrained vascular segmentation in X-ray angiographic image sequence

Background

Automatic vascular segmentation in X-ray angiographic image sequence is of crucial interest, for instance, for better quantifying coronary arteries in diagnostic and interventional procedures.

Methods

A novel inter/intra-frame constrained vascular segmentation method is proposed to automatically segment vessels in coronary X-ray angiographic image sequence. First, a morphological filter operator is applied to remove structures undergoing the respiratory motion from the original image sequence. Second, an inter-frame constrained robust principal component analysis (RPCA) is utilized to remove the quasi-static structures from the image sequence. Third, an intra-frame constrained RPCA is employed to smooth the final extracted vascular sequence. Fourth, a multi-feature fusion is designed to improve the vascular contrast and the final vascular segmentation is realized by thresholding-based method.

Results

Experiments are conducted on 22 clinical X-ray angiographic image sequences. The global and local contrast-to-noise ratio of the proposed method are 6.6344 and 4.2882, respectively. And the precision, sensitivity and F1 value are 0.7378, 0.7960 and 0.7658, respectively. It demonstrates that our method is effective and robust for vascular segmentation from image sequence.

Conclusions

The proposed method is effective to remove non-vascular structures, reduce motion artefacts and other non-uniform illumination caused noises. Also, the proposed method is online which can just process one image per time without re-optimizing the model.

A three-dimensional quantification of calcified and non-calcified plaques in coronary arteries based on computed tomography coronary angiography images: Comparison with expert's annotations and virtual histology intravascular ultrasound

The detection, quantification and characterization of coronary atherosclerotic plaques has a major effect on the diagnosis and treatment of coronary artery disease (CAD). Different studies have reported and evaluated the noninvasive ability of Computed Tomography Coronary Angiography (CTCA) to identify coronary plaque features. The identification of calcified plaques (CP) and non-calcified plaques (NCP) using CTCA has been extensively studied in cardiovascular research. However, NCP detection remains a challenging problem in CTCA imaging, due to the similar intensity values of NCP compared to the perivascular tissue, which surrounds the vasculature. In this work, we present a novel methodology for the identification of the plaque burden of the coronary artery and the volumetric quantification of CP and NCP utilizing CTCA images and we compare the findings with virtual histology intravascular ultrasound (VH-IVUS) and manual expert's annotations. Bland-Altman analyses were employed to assess the agreement between the presented methodology and VH-IVUS. The assessment of the plaque volume, the lesion length and the plaque area in 18 coronary lesions indicated excellent correlation with VH-IVUS. More specifically, for the CP lesions the correlation of plaque volume, lesion length and plaque area was 0.93, 0.84 and 0.85, respectively, whereas the correlation of plaque volume, lesion length and plaque area for the NCP lesions was 0.92, 0.95 and 0.81, respectively. In addition to this, the segmentation of the lumen, CP and NCP in 1350 CTCA slices indicated that the mean value of DICE coefficient is 0.72, 0.7 and 0.62, whereas the mean HD value is 1.95, 1.74 and 1.95, for the lumen, CP and NCP, respectively.

A Hierarchical Image Matting Model for Blood Vessel Segmentation in Fundus Images

In this paper, a hierarchical image matting model is proposed to extract blood vessels from fundus images. More specifically, a hierarchical strategy is integrated into the image matting model for blood vessel segmentation. Normally the matting models require a user specified trimap, which separates the input image into three regions: the foreground, background and unknown regions. However, creating a user specified trimap is laborious for vessel segmentation tasks. In this paper, we propose a method that first generates trimap automatically by utilizing region features of blood vessels, then applies a hierarchical image matting model to extract the vessel pixels from the unknown regions. The proposed method has low calculation time and outperforms many other state-of-art supervised and unsupervised methods. It achieves a vessel segmentation accuracy of 96.0%, 95.7% and 95.1% in an average time of 10.72s, 15.74s and 50.71s on images from three publicly available fundus image datasets DRIVE, STARE, and CHASE DB1, respectively.

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.

Toward Improving Safety in Neurosurgery with an Active Handheld Instrument

Microsurgical procedures, such as petroclival meningioma resection, require careful surgical actions in order to remove tumor tissue, while avoiding brain and vessel damaging. Such procedures are currently performed under microscope magnification. Robotic tools are emerging in order to filter surgeons' unintended movements and prevent tools from entering forbidden regions such as vascular structures. The present work investigates the use of a handheld robotic tool (Micron) to automate vessel avoidance in microsurgery. In particular, we focused on vessel segmentation, implementing a deep-learning-based segmentation strategy in microscopy images, and its integration with a feature-based passive 3D reconstruction algorithm to obtain accurate and robust vessel position. We then implemented a virtual-fixture-based strategy to control the handheld robotic tool and perform vessel avoidance. Clay vascular phantoms, lying on a background obtained from microscopy images recorded during petroclival meningioma surgery, were used for testing the segmentation and control algorithms. When testing the segmentation algorithm on 100 different phantom images, a median Dice similarity coefficient equal to 0.96 was achieved. A set of 25 Micron trials of 80 s in duration, each involving the interaction of Micron with a different vascular phantom, were recorded, with a safety distance equal to 2 mm, which was comparable to the median vessel diameter. Micron's tip entered the forbidden region 24% of the time when the control algorithm was active. However, the median penetration depth was 16.9 μm, which was two orders of magnitude lower than median vessel diameter. Results suggest the system can assist surgeons in performing safe vessel avoidance during neurosurgical procedures.

A Unified Level Set Framework Combining Hybrid Algorithms for Liver and Liver Tumor Segmentation in CT Images

Accurate and reliable segmentation of liver tissue and liver tumor is essential for the follow-up of hepatic diagnosis. In this paper, we present a method for liver segmentation and a method for liver tumor segmentation. The two methods are grounded on a novel unified level set method (LSM), which incorporates both region information and edge information to evolve the contour. This level set framework is more resistant to edge leakage than the single-information driven LSMs for liver segmentation and surpasses many other models for liver tumor segmentation. Specifically, for liver segmentation, a hybrid image preprocessing scheme is used first to convert an input CT image into a binary image. Then with manual setting of a few seed points on the obtained binary image, the following region-growing is performed to extract a rough liver region with no leakage. The unified LSM is proposed at last to refine the segmentation result. For liver tumor segmentation, a local intensity clustering based LSM coupled with hidden Markov random field and expectation-maximization (HMRF-EM) algorithm is applied to construct an enhanced edge indicator for the unified LSM. With this development, expected segmentation results can be obtained via the unified LSM, even for complex tumors. The two methods were evaluated with various datasets containing a local hospital dataset, the public datasets SLIVER07, 3Dircadb, and MIDAS via five measures. The proposed liver segmentation method outperformed other previous semiautomatic methods on the SLIVER07 dataset and required less interaction. The proposed liver tumor segmentation method was also competitive with other state-of-the-art methods in both accuracy and efficiency on the 3Dircadb database. Our methods are evaluated to be accurate and efficient, which allows their adoptions in clinical practice.

Automatic liver vessel segmentation using 3D region growing and hybrid active contour model

This paper proposes a new automatic method for liver vessel segmentation by exploiting intensity and shape constraints of 3D vessels. The core of the proposed method is to apply two different strategies: 3D region growing facilitated by bi-Gaussian filter for thin vessel segmentation, and hybrid active contour model combined with K-means clustering for thick vessel segmentation. They are then integrated to generate final segmentation results. The proposed method is validated on abdominal computed tomography angiography (CTA) images, and obtains an average accuracy, sensitivity, specificity, Dice, Jaccard, and RMSD of 98.2%, 68.3%, 99.2%, 73.0%, 66.1%, and 2.56 mm, respectively. Experimental results show that our method is capable of segmenting complex liver vessels with more continuous and complete thin vessel details, and outperforms several existing 3D vessel segmentation algorithms.

Blood vessel segmentation algorithms - Review of methods, datasets and evaluation metrics

BACKGROUND

Blood vessel segmentation is a topic of high interest in medical image analysis since the analysis of vessels is crucial for diagnosis, treatment planning and execution, and evaluation of clinical outcomes in different fields, including laryngology, neurosurgery and ophthalmology. Automatic or semi-automatic vessel segmentation can support clinicians in performing these tasks. Different medical imaging techniques are currently used in clinical practice and an appropriate choice of the segmentation algorithm is mandatory to deal with the adopted imaging technique characteristics (e.g. resolution, noise and vessel contrast).

OBJECTIVE

This paper aims at reviewing the most recent and innovative blood vessel segmentation algorithms. Among the algorithms and approaches considered, we deeply investigated the most novel blood vessel segmentation including machine learning, deformable model, and tracking-based approaches.

METHODS

This paper analyzes more than 100 articles focused on blood vessel segmentation methods. For each analyzed approach, summary tables are presented reporting imaging technique used, anatomical region and performance measures employed. Benefits and disadvantages of each method are highlighted.

DISCUSSION

Despite the constant progress and efforts addressed in the field, several issues still need to be overcome. A relevant limitation consists in the segmentation of pathological vessels. Unfortunately, not consistent research effort has been addressed to this issue yet. Research is needed since some of the main assumptions made for healthy vessels (such as linearity and circular cross-section) do not hold in pathological tissues, which on the other hand require new vessel model formulations. Moreover, image intensity drops, noise and low contrast still represent an important obstacle for the achievement of a high-quality enhancement. This is particularly true for optical imaging, where the image quality is usually lower in terms of noise and contrast with respect to magnetic resonance and computer tomography angiography.

CONCLUSION

No single segmentation approach is suitable for all the different anatomical region or imaging modalities, thus the primary goal of this review was to provide an up to date source of information about the state of the art of the vessel segmentation algorithms so that the most suitable methods can be chosen according to the specific task.

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.

Automatic 2-D/3-D Vessel Enhancement in Multiple Modality Images Using a Weighted Symmetry Filter

Automated detection of vascular structures is of great importance in understanding the mechanism, diagnosis, and treatment of many vascular pathologies. However, automatic vascular detection continues to be an open issue because of difficulties posed by multiple factors, such as poor contrast, inhomogeneous backgrounds, anatomical variations, and the presence of noise during image acquisition. In this paper, we propose a novel 2-D/3-D symmetry filter to tackle these challenging issues for enhancing vessels from different imaging modalities. The proposed filter not only considers local phase features by using a quadrature filter to distinguish between lines and edges, but also uses the weighted geometric mean of the blurred and shifted responses of the quadrature filter, which allows more tolerance of vessels with irregular appearance. As a result, this filter shows a strong response to the vascular features under typical imaging conditions. Results based on eight publicly available datasets (six 2-D data sets, one 3-D data set, and one 3-D synthetic data set) demonstrate its superior performance to other state-of-the-art methods.

Combining deep learning with anatomical analysis for segmentation of the portal vein for liver SBRT planning

Automated segmentation of the portal vein (PV) for liver radiotherapy planning is a challenging task due to potentially low vasculature contrast, complex PV anatomy and image artifacts originated from fiducial markers and vasculature stents. In this paper, we propose a novel framework for automated segmentation of the PV from computed tomography (CT) images. We apply convolutional neural networks (CNNs) to learn the consistent appearance patterns of the PV using a training set of CT images with reference annotations and then enhance the PV in previously unseen CT images. Markov random fields (MRFs) were further used to smooth the results of the enhancement of the CNN enhancement and remove isolated mis-segmented regions. Finally, CNN-MRF-based enhancement was augmented with PV centerline detection that relied on PV anatomical properties such as tubularity and branch composition. The framework was validated on a clinical database with 72 CT images of patients scheduled for liver stereotactic body radiation therapy. The obtained accuracy of the segmentation was [Formula: see text] 0.83 and [Formula: see text] 1.08 mm in terms of the median Dice coefficient and mean symmetric surface distance, respectively, when segmentation is encompassed into the PV region of interest. The obtained results indicate that CNNs and anatomical analysis can be used for the accurate segmentation of the PV and potentially integrated into liver radiation therapy planning.

Liver vessel segmentation and identification based on oriented flux symmetry and graph cuts

BACKGROUND AND OBJECTIVE

Accurate segmentation of liver vessels from abdominal computer tomography angiography (CTA) volume is very important for liver-vessel analysis and living-related liver transplants. This paper presents a novel liver-vessel segmentation and identification method.

METHODS

Firstly, an anisotropic diffusion filter is used to smooth noise while preserving vessel boundaries. Then, based on the gradient symmetry and antisymmetry pattern of vessel structures, optimal oriented flux (OOF) and oriented flux antisymmetry (OFA) measures are respectively applied to detect liver vessels and their boundaries, and further to slenderize vessels. Next, according to vessel geometrical structure, a centerline extraction measure based on height ridge traversal and leaf node line-growing (LNLG) is proposed for the extraction of liver-vessel centerlines, and an intensity model based on fast marching is integrated into graph cuts (GCs) for effective segmentation of liver vessels. Finally, a distance voting mechanism is applied to separate the hepatic vein and portal vein.

RESULTS

The experiment results on abdominal CTA images show that the proposed method can effectively segment liver vessels, achieving an average accuracy, sensitivity, and specificity of 97.7%, 79.8%, and 98.6%, respectively, and has a good performance on thin-vessel extraction.

CONCLUSIONS

The proposed method does not require manual selection of the centerlines and vessel seeds, and can effectively segment liver vessels and identify hepatic vein and portal vein.

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.

Vessel segmentation from abdominal magnetic resonance images: adaptive and reconstructive approach

The liver vessels, which have low signal and run next to brighter bile ducts, are difficult to segment from MR images. This study presents a fully automated and adaptive method to segment portal and hepatic veins on magnetic resonance images. In the proposed approach, segmentation of these vessels is achieved in four stages: (i) initial segmentation, (ii) refinement, (iii) reconstruction, and (iv) post-processing. In the initial segmentation stage, k-means clustering is used, the results of which are refined iteratively with linear contrast stretching algorithm in the next stage, generating a mask image. In the reconstruction stage, vessel regions are reconstructed with the marker image from the first stage and the mask image from the second stage. Experimental data sets include slices that show fat tissues, which have the same gray level values with vessels, outside the margin of the liver. These structures are removed in the last stage. Results show that the proposed approach is more efficient than other thresholding-based methods. Copyright © 2016 John Wiley & Sons, Ltd.