Single-seeded coronary artery tracking in CT angiography

A new algorithm for rapid and accurate segmentation of the coronary arterial tree in CT angiography data sets is presented. Each artery is fully tracked from the aortic origin to its distal end, following a single touch by the user anywhere along the vessel. A two-level front propagation technique is applied for the tracking of each vessel. An initial bottom-hat filtering, an adaptive threshold and a heuristic credit system are incorporated to overcome the pitfalls characterizing the coronary environment like the adjacent veins, the proximate chambers and the changing gray level along the artery. The aortic origin and the distal end of each vessel are determined automatically based on specific stopping criteria. An additional seed placed at the aortic root is used to complete the extraction of the entire coronary tree for an overall examination. The algorithm used for the segmentation of the aortic root region is a planar front propagation based on watershed segmentation and an adaptive erosion technique that are needed to avoid leakage into the atria in cases of artifacts or poor image quality. The results of the proposed methodology were evaluated in 34 patients. Artery tracking was proved to be highly robust for images of medium and high quality.