Method details

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Precise Lumen Segmentation in Coronary Computed Tomography Angiography



Abstract:
Coronary computed tomography angiography (CCTA) allows for non-invasive identification and grading of stenoses by evaluating the degree of narrowing of the blood-filled vessel lumen. Recently, methods have been proposed that simulate coronary blood ow using computational uid dynamics (CFD) to compute the fractional flow reserve non-invasively. Both grading and CFD rely on a precise segmentation of the vessel lumen from CCTA. We propose a novel, model-guided segmentation approach based on a Markov random field formulation with convex priors which assures the preservation of the tubular structure of the coronary lumen. Allowing for various robust smoothness terms, the approach yields very accurate lumen segmentations even in the presence of calcified and non-calcified plaques. Evaluations on the public Rotterdam segmentation challenge demonstrate the robustness and accuracy of our method: on standardized tests with multi-vendor CCTA from 30 symptomatic patients, we achieve superior accuracies as compared to both state-of-the-art methods and medical experts.

Detection confusion tables

Calc. cat.QCA (per segment)CTA (per lesion)
 TPFPFNTP+FPTP+FNTPFPFNTP+FPTP+FN
All  15  53  13  68  28  23  60  24  83  47 
The results of this method are based on the following centerlines: own or none.

Detection (QCA per segment / CTA per lesion)

Calc. cat.QCA
Sens.
QCA
P.P.V.
CTA
Sens.
CTA
P.P.V.
Avg. rank
 %rank%rank%rank%rank 
0 (0 - 0.1)  40.0  8.0  22.2  7.0  42.9  7.0  27.3  7.0  7.2 
1 (0.1 - 10)  100.0  1.0  33.3  3.0  60.0  6.0  60.0  8.0  4.5 
2 (11 - 100)  28.6  13.0  16.7  13.0  36.4  12.0  25.0  8.0  11.5 
3 (101 - 400)  70.0  6.0  22.6  10.0  52.6  7.0  30.3  8.0  7.8 
4 (400+)  60.0  4.0  23.1  11.0  60.0  6.0  16.7  11.0  8.0 
All  53.6  10.0  22.1  10.0  48.9  10.0  27.7  8.0  9.5 
For ranking  53.6  10.0  22.1  10.0  48.9  10.0  27.7  8.0  9.5 
These results are based on 30 datasets and 19 submissions.


Quantification

Calc. cat.QCA
Avg. Abs. diff.
QCA
R.M.S. diff.
CTA
Weigthed Kappa
Avg. rank
 %rank%rankΚrank 
0 (0 - 0.1)  48.1  14.0  54.6  14.0  0.21  8.0  11.0 
1 (0.1 - 10)  31.9  6.0  35.9  6.0  0.41  5.0  5.5 
2 (11 - 100)  51.8  13.0  55.9  14.0  0.30  6.0  9.8 
3 (101 - 400)  51.0  14.0  55.7  14.0  0.32  7.0  10.5 
4 (400+)  57.8  13.0  64.7  13.0  0.33  7.0  10.0 
All  50.0  13.0  55.6  14.0  0.32  6.0  9.8 
For ranking  50.0  13.0  55.6  14.0  0.32  6.0  9.8