Automatic correction of gaps in cerebrovascular segmentations extracted from 3D time-of-flight MRA datasets

Objectives: Exact cerebrovascular segmentations are required for several applications in today's clinical routine. A major drawback of typical automatic segmentation methods is the occurrence of gaps within the segmentation. These gaps are typically located at small vessel structures exhibiting low intensities. Manual correction is very time-consuming and not suitable in clinical practice. This work presents a post-processing method for the automatic detection and closing of gaps in cerebrovascular segmentations. Methods: In this approach, the 3D centerline is calculated from an available vessel segmentation, which enables the detection of corresponding vessel endpoints. These endpoints are then used to detect possible connections to other 3D centerline voxels with a graphbased approach. After consistency check, rea-sonable detected paths are expanded to the vessel boundaries using a level set approach and combined with the initial segmentation. Results: For evaluation purposes, 100 gaps were artificially inserted at non-branching vessels and bifurcations in manual cerebro -vascular segmentations derived from ten Time-of-Flight magnetic resonance angiography datasets. The results show that the presented method is capable of detecting 82% of the non-branching vessel gaps and 84% of the bifurcation gaps. The level set segmentation expands the detected connections with 0.42 mm accuracy compared to the initial segmentations. A further evaluation based on 10 real automatic segmentations from the same datasets shows that the proposed method detects 35 additional connections in average per dataset, whereas 92.7% were rated as correct by a medical expert. Conclusion: The presented approach can considerably improve the accuracy of cerebro -vascular segmentations and of following analysis outcomes.