Magnetic resonance angiography in evaluation of acute intracranial steno-occlusive arterial disease

BV-GAN: 3D time-of-flight magnetic resonance angiography cerebrovascular vessel segmentation using adversarial CNNs

Purpose: Cerebrovascular vessel segmentation is a key step in the detection of vessel pathology. Brain time-of-flight magnetic resonance angiography (TOF-MRA) is a main method used clinically for imaging of blood vessels using magnetic resonance imaging. This method is primarily used to detect narrowing, blockage of the arteries, and aneurysms. Despite its importance, TOF-MRA interpretation relies mostly on visual, subjective assessment performed by a neuroradiologist and is mostly based on maximum intensity projections reconstruction of the three-dimensional (3D) scan, thus reducing the acquired spatial resolution. Works tackling the central problem of automatically segmenting brain blood vessels typically suffer from memory and imbalance related issues. To address these issues, the spatial context of the segmentation consider by neural networks is typically restricted (e.g., by resolution reduction or analysis of environments of lower dimensions). Although efficient, such solutions hinder the ability of the neural networks to understand the complex 3D structures typical of the cerebrovascular system and to leverage this understanding for decision making. Approach: We propose a brain-vessels generative-adversarial-network (BV-GAN) segmentation model, that better considers connectivity and structural integrity, using prior based attention and adversarial learning techniques. Results: For evaluations, fivefold cross-validation experiments were performed on two datasets. BV-GAN demonstrates consistent improvement of up to 10% in vessel Dice score with each additive designed component to the baseline state-of-the-art models. Conclusions: Potentially, this automated 3D-approach could shorten analysis time, allow for quantitative characterization of vascular structures, and reduce the need to decrease resolution, overall improving diagnosis cerebrovascular vessel disorders.