A Fully Integrated Pipeline for Visual Carotid Morphology Analysis

Analyzing stenoses of the internal carotids – local constrictions of the artery – is a critical clinical task in cardiovascular disease treatment and prevention. For this purpose, we propose a self-contained pipeline for the visual analysis of carotid artery geometries. The only inputs are computed tomography angiography (CTA) scans, which are already recorded in clinical routine. We show how integrated model extraction and visualization can help to efficiently detect stenoses and we provide means for automatic, highly accurate stenosis degree computation. We directly connect multiple sophisticated processing stages, including a neural prediction network for lumen and plaque segmentation and automatic global diameter computation. We enable interactive and retrospective user control over the processing stages. Our aims are to increase user trust by making the underlying data validatable on the fly, to decrease adoption costs by minimizing external dependencies, and to optimize scalability by streamlining the data processing. We use interactive visualizations for data inspection and adaption to guide the user through the processing stages. The framework was developed and evaluated in close collaboration with radiologists and neurologists. It has been used to extract and analyze over 100 carotid bifurcation geometries and is built with a modular architecture, available as an extendable open-source platform.