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Background: Segmentation of coronary arteries in computed tomography angiography (CTA) images plays a key role in the diagnosis and treatment of coronary-related diseases. However, manually analyzing the large amount of data is time-consuming, and interpreting this data requires the prior knowledge and expertise of radiologists. Therefore, an automatic method is needed to separate coronary arteries from a given CTA dataset. Methods: Firstly, an anisotropic diffusion filter was employed to smooth the noise while preserving the vessel boundaries. The coronary skeleton was then extracted using a two-step process based on the intensity of the coronary. In the first step, the thick vessel skeleton was extracted by clustering, improved vesselness filtering and region growing, while in the second step, the thin vessel skeleton was extracted by the height ridge traversal method guided by the cylindrical model. Next, the vesselness measure, representing vessel a priori information, was incorporated into the local region active contour model based on the vessel geometry. Finally, the initial contour of the active contour model was generated using the coronary artery skeleton for effective segmentation of the three-dimensional (3D) coronary arteries. Results: Experimental results on chest CTA images show that the method is able to segment coronary arteries effectively with an average precision, recall and dice similarity coefficient (DSC) of 86.64%, 91.26% and 79.13%, respectively, and has a good performance in thin vessel extraction. Conclusions: The method does not require manual selection of vessel seeds or setting of initial contours, and allows for the extraction of a successful coronary artery skeleton and eventual effective segmentation of the coronary arteries.
Chen et al. (Mon,) studied this question.