Model-based quantitative AAA image analysis using a priori knowledge

Abdominal aortic aneurysm (AAA) is a serious vascular disease which may have a fatal outcome. AAA shape and size is important for diagnostics and intervention planning. In this paper, we present a new method for segmentation of AAA from computed tomography (CT) angiography images. The method works by segmenting the inner and the outer aortic border. Segmentation of AAA is a challenging problem because of low contrast of the outer aortic border. In our method, the inner aortic border is segmented using a geometric deformable model (GDM) and morphological postprocessing. The GDM is implemented using the level-set algorithm. The outer aortic border is segmented by a preprocessing method utilizing a priori knowledge about the aorta shape, followed by the GDM-based method, and morphological postprocessing. The preprocessing algorithm operates on a slice-by-slice basis with some information flow among neighboring slices. The GDM performs three-dimensional (3D) segmentation, reducing possible errors in the previous step. The proposed method is automatic and requires minimal user assistance. The method was statistically validated on 12 patient scans having a total number of 497 image slices. Statistical analysis has confirmed high correlation between the results obtained by the proposed method and the gold standard obtained by manual segmentation by an expert radiologist.