Automatic segmentation of coronary arteries in CT imaging in the presence of kissing vessel artifacts

In this paper, we present a novel two-step algorithm for segmentation of coronary arteries in computed tomography images based on the framework of active contours. In the proposed method, both global and local intensity information is utilized in the energy calculation. The global term is defined as a normalized cumulative distribution function, which contributes to the overall active contour energy in an adaptive fashion based on image histograms, to deform the active contour away from local stationary points. Possible outliers, such as kissing vessel artifacts, are removed in the postprocessing stage by a slice-by-slice correction scheme based on multiregion competition, where both arteries and kissing vessels are identified and tracked through the slices. The efficiency and the accuracy of the proposed technique are demonstrated on both synthetic and real datasets. The results on clinical datasets show that the method is able to extract the major branches of arteries with an average distance of 0.73 voxels to the manually delineated ground truth data. In the presence of kissing vessel artifacts, the outer surface of the entire coronary tree, extracted by the proposed algorithm, is smooth and contains fewer erroneous regions, originating in kissing vessel artifacts, as compared to the initial segmentation.