Carotid vasculature modeling from patient CT angiography studies for interventional procedures simulation

M. Freiman*, L. Joskowicz, N. Broide, M. Natanzon, E. Nammer, O. Shilon, L. Weizman, J. Sosna

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Objective: 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. Materials and methods: 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. Results: 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 MentorTM simulator platform are robust, realistic, and greatly improve the simulation. Conclusion: This constitutes a proof-of-concept that patient-specific CTA-based modeling and simulation of carotid interventional procedures are practical in a clinical environment.

Original languageAmerican English
Pages (from-to)799-812
Number of pages14
JournalInternational journal of computer assisted radiology and surgery
Issue number5
StatePublished - Sep 2012

Bibliographical note

Funding Information:
Acknowledgments This research is supported in part by MAGNETON grant 38652 from the Israeli Ministry of Trade and Industry. Moti Freiman was also supported in part by the Hebrew University Hoffman Leadership and the Responsibility Fellowship Program. We are grateful to Phillip Berman, Department of Radiology, Hadassah-Hebrew University Medical Center, for his assistance with the Hadassah datasets. The method described in this paper is used for research only and is not part of the commercial Simbionix Ltd. ANGIO Mentor simulator.


  • CTA
  • Carotid arteries
  • Model-based graph-cut
  • Segmentation


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