High Accuracy Pulmonary Vessel Segmentation for Contrast and Non-contrast CT Images and Clinical Evaluation

Accurate segmentation of pulmonary vessels plays a very critical role in diagnosing and assessing various lung diseases. Currently, many automated algorithms are primarily targeted at CTPA (Computed Tomography Pulmonary Angiography) types of data. However, the segmentation precision of these methods is insufficient, and support for NCCT (Non-Contrast Computed Tomography) types of data is also a requirement in some clinical scenarios. In this study, we propose a 3D image segmentation algorithm for automated pulmonary vessel segmentation from both contrast-enhanced and non-contrast CT images. In the network, we designed a Vessel Lumen Structure Optimization Module (VLSOM), which extracts the centerline (Cl) of vessels and adjusts the weights based on the positional information and adds a Cl-Dice Loss to supervise the stability of the vessels structure. We used 427 sets of high-precision annotated CT data from multiple vendors and countries to train the model and achieved Cl-DICE, Cl-Recall, and Recall values of 0.892, 0.861, 0.924 for CTPA data and 0.925, 0.903, 0.949 for NCCT data. This shows that our model has achieved good performance in both accuracy and completeness of pulmonary vessel segmentation. We finally conducted a clinical visual assessment on an independent external test dataset. The average score for accuracy and robustness, branch abundance, assistance for diagnosis and vascular continuity are 4.26, 4.17, 4.33, 3.83 respectively while the full score is 5. These results highlight the great potential of this method in clinical application.