Fast automatic delineation of cardiac volume of interest in MSCT images

Computed Tomography Angiography (CTA) is an emerging modality for assessing cardiac anatomy. The delineation of the cardiac volume of interest (VOI) is a pre-processing step for subsequent visualization or image processing. It serves the suppression of anatomic structures being not in the primary focus of the cardiac application, such as sternum, ribs, spinal column, descending aorta and pulmonary vasculature. These structures obliterate standard visualizations such as direct volume renderings or maximum intensity projections. In addition, outcome and performance of post-processing steps such as ventricle suppression, coronary artery segmentation or the detection of short and long axes of the heart can be improved. The structures being part of the cardiac VOI (coronary arteries and veins, myocardium, ventricles and atria) differ tremendously in appearance. In addition, there is no clear image feature associated with the contour (or better cut-surface) distinguishing between cardiac VOI and surrounding tissue making the automatic delineation of the cardiac VOI a difficult task. The presented approach locates in a first step chest wall and descending aorta in all image slices giving a rough estimate of the location of the heart. In a second step, a Fourier based active contour approach delineates slice-wise the border of the cardiac VOI. The algorithm has been evaluated on 41 multi-slice CT data-sets including cases with coronary stents and venous and arterial bypasses. The typical processing time amounts to 5-10s on a 1GHz P3 PC.