title: Automated coronary artery tree extraction in coronary CT angiography using a multiscale enhancement and dynamic balloon tracking (MSCAR-DBT) method.
abstract: OBJECTIVE
  To evaluate our prototype method for segmentation and tracking of the coronary arterial tree, which is the foundation for a computer-aided detection (CADe) system to be developed to assist radiologists in detecting non-calcified plaques in coronary CT angiography (cCTA) scans.
  
  
  METHODS
  The heart region was first extracted by a morphological operation and an adaptive thresholding method based on expectation-maximization (EM) estimation. The vascular structures within the heart region were enhanced and segmented using a multiscale coronary response (MSCAR) method that combined 3D multiscale filtering, analysis of the eigenvalues of Hessian matrices and EM estimation segmentation. After the segmentation of vascular structures, the coronary arteries were tracked by a 3D dynamic balloon tracking (DBT) method. The DBT method started at two manually identified seed points located at the origins of the left and right coronary arteries (LCA and RCA) for extraction of the arterial trees. The coronary arterial trees of a data set containing 20 ECG-gated contrast-enhanced cCTA scans were extracted by our MSCAR-DBT method and a clinical GE Advantage workstation. Two experienced thoracic radiologists visually examined the coronary arteries on the original cCTA scans and the rendered volume of segmented vessels to count the untracked false-negative (FN) segments and false positives (FPs) for both methods.
  
  
  RESULTS
  For the visible coronary arterial segments in the 20 cases, the radiologists identified that 25 segments were missed by our MSCAR-DBT method, ranging from 0 to 5 FN segments in individual cases, and that 55 artery segments were missed by the GE software, ranging from 0 to 7 FN segments in individual cases. 19 and 15 FPs were identified in our and the GE coronary trees, ranging from 0 to 4 FPs for both methods in individual cases, respectively.
  
  
  CONCLUSIONS
  The preliminary study demonstrates the feasibility of our MSCAR-DBT method for segmentation and tracking coronary artery trees. The results indicated that both our method and GE software can extract coronary artery trees reasonably well and the performance of our method is superior to that of GE software in this small data set. Further studies are underway to develop methods for improvement of the segmentation and tracking accuracy.
authors: Department of Radiology, University of Michigan, Ann Arbor 48109, USA. chuan@umich.edu
authors: Chuan
authors: C
authors: Zhou
authors: Heang-Ping
authors: HP
authors: Chan
authors: Aamer
authors: A
authors: Chughtai
authors: Smita
authors: S
authors: Patel
authors: Lubomir M
authors: LM
authors: Hadjiiski
authors: Jun
authors: J
authors: Wei
authors: Ella A
authors: EA
authors: Kazerooni
references: Am J Cardiol. 2006 Jan 15;97(2):173-4
references: 16442357
references: Med Image Anal. 2001 Sep;5(3):195-206
references: 11524226
references: J Am Coll Cardiol. 2008 Nov 18;52(21):1724-32
references: 19007693
references: Circulation. 2009 Jan 27;119(3):e21-181
references: 19075105
references: Radiology. 1998 Mar;206(3):823-9
references: 9494508
references: Med Image Anal. 1998 Jun;2(2):143-68
references: 10646760
references: J Med Screen. 1999;6(3):152-8
references: 10572847
references: Med Phys. 2009 Dec;36(12):5568-79
references: 20095269
references: Circulation. 2006 Oct 17;114(16):1761-91
references: 17015792
references: IEEE Trans Med Imaging. 2002 Feb;21(2):61-75
references: 11929106
references: Med Phys. 2003 Aug;30(8):2040-51
references: 12945970
references: J Comput Assist Tomogr. 2001 Jul-Aug;25(4):587-97
references: 11473191
references: Circulation. 1975 Apr;51(4 Suppl):5-40
references: 1116248
references: Med Phys. 2007 Dec;34(12):4567-77
references: 18196782
references: Med Image Anal. 2000 Jun;4(2):73-91
references: 10972323
references: Med Image Anal. 2009 Oct;13(5):701-14
references: 19632885
references: JAMA. 2006 Jul 26;296(4):403-11
references: 16868298
references: J Am Coll Cardiol. 2007 Sep 18;50(12):1161-70
references: 17868808
references: Comput Med Imaging Graph. 1998 Mar-Apr;22(2):157-67
references: 9719856
references: IEEE Trans Med Imaging. 1996;15(1):51-8
references: 18215888
references: IEEE Trans Med Imaging. 1996;15(3):377-85
references: 18215918