Vascular segmentation is often required in medical image analysis for various imaging modalities. Despite the rich literature in the field, the proposed methods need most of the time adaptation to the particular investigation and may sometimes lack the desired accuracy in terms of true positive and false positive detection rate. This paper proposes a general method for vascular segmentation based on locally connected filtering applied in a multiresolution scheme. The filtering scheme performs progressive detection and removal of the vessels from the image relief at each resolution level, by combining directional 2D-3D locally connected filters (LCF). An important property of the LCF is that it preserves (positive contrasted) structures in the image if they are topologically connected with other similar structures in their local environment. Vessels, which appear as linear structures, can be filtered out by an appropriate LCF set-up which will minimally affect sheet-like structures. The implementation in a multiresolution framework allows dealing with different vessel sizes. The outcome of the proposed approach is illustrated on two anatomical territories - lung and liver. It is shown that besides preserving high accuracy in detecting small vessels, the proposed technique is less sensitive with respect to noise and the presence of pathologies of positive-contrast appearance on the images. The detection accuracy is compared with a previously developed approach on the 20 patient database from the VESSEL12 challenge.
Hereditary hemorrhagic telangiectasia (HHT) is an autosomic dominant disorder, which is characterized by the development of multiple arterio-venous malformations in the skin, mucous membranes, and/or visceral organs. Pulmonary Arterio-Venous Malformation (PAVM) is an abnormal connection where feeding arteries shunt directly into draining veins with no intervening capillary bed. This condition may lead to paradoxical embolism and hemorrhagic complications. PAVMs patients should systematically be screened as the spontaneous complication rate is high, reaching almost 50%. Chest enhanced contrast CT scanner is the reference screening and follow-up examination. When performed by experienced operators as the prime treatment, percutaneous embolization of PAVMs is a safe, efficient and sustained therapy. The accuracy of PAVM detection and quantification of its progression over time is the key of embolotherapy success. In this paper, we propose an automatic method for PAVM detection and quantification relying on a modeling of vessel deformation, i.e. local caliber increase, based on mathematical morphology. The pulmonary field and vessels are first segmented using geodesic operators. The vessel caliber is estimated by means of a granulometric measure and the local caliber increase is detected by using a geodesic operator, the h-maxdomes. The detection sensitivity can be tuned up according to the choice of the h value which models the irregularity of the vessel caliber along its axis and the PAVM selection is performed according to a clinical criterion of >3 mm diameter of the feeding artery of the PAVM. The developed method was tested on a 20 patient dataset. A sensitivity study allowed choosing the irregularity parameter to maximize the true positive ratio reaching 85.4% in average. A specific false positive reduction procedure targeting the vessel trunks of the arterio-venous tree near mediastinum allows a precision increase from 13% to 67% with an average number of 1.15 false positives per scan.
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