Level Set Segmentation and Volume Visualization of Vascular Trees

Medical imaging is an important part of the clinical workflow. With the increasing amount and complexity of image data comes the need for automatic (or semi-automatic) analysis methods which aid the physician in the exploration of the data. One specific imaging technique is angiography, in which the blood vessels are imaged using an injected contrast agent which increases the contrast between blood and surrounding tissue. In these images, the blood vessels can be viewed as tubular structures with varying diameters. Deviations from this structure are signs of disease, such as stenoses introducing reduced blood flow, or aneurysms with a risk of rupture. This thesis focuses on segmentation and visualization of blood vessels, consituting the vascular tree, in angiography images. Segmentation is the problem of partitioning an image into separate regions. There is no general segmentation method which achieves good results for all possible applications. Instead, algorithms use prior knowledge and data models adapted to the problem at hand for good performance. We study blood vessel segmentation based on a two-step approach. First, we model the vessels as a collection of linear structures which are detected using multi-scale filtering techniques. Second, we develop machine-learning based level set segmentation methods to separate the vessels from the background, based on the output of the filtering. In many applications the three-dimensional structure of the vascular tree has to be presented to a radiologist or a member of the medical staff. For this, a visualization technique such as direct volume rendering is often used. In the case of computed tomography angiography one has to take into account that the image depends on both the geometrical structure of the vascular tree and the varying concentration of the injected contrast agent. The visualization should have an easy to understand interpretation for the user, to make diagnostical interpretations reliable. The mapping from the image data to the visualization should therefore closely follow routines that are commonly used by the radiologist. We developed an automatic method which adapts the visualization locally to the contrast agent, revealing a larger portion of the vascular tree while minimizing the manual intervention required from the radiologist. The effectiveness of this method is evaluated in a user study involving radiologists as domain experts