Abstract

Quantitative analysis of blood vessel wall structures is important to study atherosclerotic diseases and assess cardiovascular event risks. To achieve this, accurate identification of vessel luminal and outer wall contours is needed. Computer-assisted tools exist, but manual preprocessing steps, such as region of interest identification and/or boundary initialization, are still needed. In addition, prior knowledge of the ring shape of vessel walls has not been fully explored in designing segmentation methods. In this work, a fully automated artery localization and vessel wall segmentation system is proposed. A tracklet refinement algorithm was adapted to robustly identify the artery of interest from a neural network-based artery centerline identification architecture. Image patches were extracted from the centerlines and converted in a polar coordinate system for vessel wall segmentation. The segmentation method used 3D polar information and overcame problems such as contour discontinuity, complex vessel geometry, and interference from neighboring vessels. Verified by a large (>32000 images) carotid artery dataset collected from multiple sites, the proposed system was shown to better automatically segment the vessel wall than traditional vessel wall segmentation methods or standard convolutional neural network approaches. In addition, a segmentation uncertainty score was estimated to effectively identify slices likely to have errors and prompt manual confirmation of the segmentation. This robust vessel wall segmentation system has applications in different vascular beds and will facilitate vessel wall feature extraction and cardiovascular risk assessment.

Highlights

  • Atherosclerotic cardiovascular disease is a leading cause of death worldwide [1]

  • magnetic resonance imaging (MRI) provides a quantitative analysis of atherosclerotic burden, which can be exploited for monitoring disease progression in serial studies and clinical trials [5], [6]

  • Inner and outer boundaries of arterial walls visible in the axial planes on each slice of the MR images need to be drawn on each slice [7], which is tedious and subject to VOLUME XX, 2017

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Summary

INTRODUCTION

Atherosclerotic cardiovascular disease is a leading cause of death worldwide [1]. Angiographic techniques are commonly used to depict luminal stenosis resulting from atherosclerosis progression. Hough circle detection has been attempted to detect arterial centers, under the assumption that arteries are circular in shape [18] These methods reduce some manual steps and show reasonable agreement for images with high vessel wall contrast. Several major obstacles exist, preventing our deep learning-based algorithms from being effectively used: (1) the target artery cannot be automatically identified in the presence of multiple arteries; (2) some prior knowledge, for example, vessel wall contours should be closed rings, is not used (see Figure 1 for a problematic case); and (3) information from neighboring slices is not well used to refine the segmentation results. Polar regression provided unique benefits, including better vessel wall continuity and improved segmentation, which is especially needed in challenging slices near arterial bifurcations where the artery shape is no longer circular.

PROPOSED LOCALIZATION AND SEGMENTATION METHODOLOGIES
Polar Regression CNN Architecture
Patch Rotation
EXPERIMENTAL DATA SETUP AND RESULTS
DISCUSSION
Findings
CONCLUSION
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