We propose and validate a semi-automatic method for lumen segmentation of the carotid bifurcation in computed tomography angiography (CTA). First, the central vessel axis is obtained using path tracking between three user-defined points. Second, starting from this path, the segmentation is automatically obtained using a level set. The cost and speed functions for path tracking and segmentation make use of intensity and homogeneity slice-based image features. The method is validated on a large data set of 234 carotid bifurcations of 129 ischemic stroke patients with atherosclerotic disease. The results are compared to manually obtained lumen segmentations. Parameter optimization is carried out on a subset of 30 representative carotid bifurcations. With the optimized parameter settings the method successfully tracked the central vessel paths in 201 of the remaining 204 bifurcations (99%) which were not part of the training set. Comparison with manually drawn segmentations shows that the average overlap between the method and observers is similar (for the inter-observer set the results were 92% vs. 87% and for the intra-observer set 94% vs. 94%). Therefore the method has potential to replace the manual procedure of lumen segmentation of the atherosclerotic bifurcation in CTA. © 2010 Elsevier B.V.

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Keywords Atherosclerotic carotid bifurcation, CT angiography (CTA), Evaluation, Level set, Lumen segmentation
Persistent URL dx.doi.org/10.1016/j.media.2010.05.001, hdl.handle.net/1765/20478
Journal Medical Image Analysis
Manniesing, R, Schaap, M, Rozie, S, Hameeteman, R, Vukadinovic, D, van der Lugt, A, & Niessen, W.J. (2010). Robust CTA lumen segmentation of the atherosclerotic carotid artery bifurcation in a large patient population. Medical Image Analysis, 14(6), 759–769. doi:10.1016/j.media.2010.05.001