School of Engineering and Computer Science, The Hebrew University of Jerusalem, Jerusalem, Israel.
Int J Comput Assist Radiol Surg. 2012 Sep;7(5):799-812. doi: 10.1007/s11548-012-0673-x. Epub 2012 Feb 29.
A practical method for patient-specific modeling of the aortic arch and the entire carotid vasculature from computed tomography angiography (CTA) scans for morphologic analysis and for interventional procedure simulation.
The method starts with the automatic watershed-based segmentation of the aorta and the construction of an a-priori intensity probability distribution function for arteries. The carotid arteries are then segmented with a graph min-cut method based on a new edge weighting function that adaptively couples voxel intensity, intensity prior, and local vesselness shape prior. Finally, the same graph-cut optimization framework is used to interactively remove a few unwanted veins segments and to fill in minor vessel discontinuities caused by intensity variations.
We validate our modeling method with two experimental studies on 71 multicenter clinical CTA datasets, including carotid bifurcation lumen segmentation on 56 CTAs from the MICCAI'2009 3D Segmentation Challenge. Segmentation results show that our method is comparable to the best existing methods and was successful in modeling the entire carotid vasculature with a Dice similarity measure of 84.5% (SD = 3.3%) and MSSD 0.48 mm (SD = 0.12 mm.) Simulation study shows that patient-specific simulations with four patient-specific models generated by our segmentation method on the ANGIO Mentor™ simulator platform are robust, realistic, and greatly improve the simulation.
This constitutes a proof-of-concept that patient-specific CTA-based modeling and simulation of carotid interventional procedures are practical in a clinical environment.
从 CT 血管造影（CTA）扫描中为形态分析和介入手术模拟，针对特定患者的主动脉弓和整个颈动脉血管进行建模，提供一种实用的方法。
该方法从基于分水岭的主动脉自动分割和动脉的先验强度概率分布函数构建开始。然后，使用基于新边缘加权函数的图最小割方法分割颈动脉，该函数自适应地结合体素强度、强度先验和局部血管形状先验。最后，使用相同的图割优化框架，交互地去除几个不需要的静脉段，并填充由强度变化引起的小血管不连续性。
我们通过两项针对 71 个多中心临床 CTA 数据集的实验研究验证了我们的建模方法，包括 MICCAI'2009 3D 分割挑战赛中的 56 个 CTA 的颈动脉分叉管腔分割。分割结果表明，我们的方法与现有最好的方法相当，对整个颈动脉血管建模的 Dice 相似性度量值达到 84.5%（SD=3.3%），均方根差为 0.48 毫米（SD=0.12 毫米）。模拟研究表明，在 ANGIO Mentor™模拟器平台上，使用我们的分割方法生成的四个特定患者模型进行特定患者的模拟是稳健、真实的，并且极大地改善了模拟。
这证明了在临床环境中，基于 CTA 的特定患者的颈动脉介入手术建模和模拟是可行的。
