Automatic Segmentation of Abdominal Aortic Aneurysm From Computed Tomography Angiography Using a Patch-Based Dilated UNet Model

Abdominal Aortic Aneurysm (AAA) is still a socially relevant public health challenge, evidenced by an 82.1% increase in associated fatalities from 1990 to 2019 (with 172,427 deaths in 2019 alone). In a clinical setting, computed tomography angiography (CTA) is the imaging modality of choice for monitoring and/or presurgical planning of AAA patients. However, manual segmentation of CTA images is labor intensive and time consuming. Hence, there is a growing need for automated segmentation algorithms, particularly when these influence treatment planning. The deep-learning pipeline proposed in this work is designed to automatically segment AAA CTA images. The framework adapted a fully developed patch-based dilated modified U-Net model, which shows remarkable efficiency in accurately delineating AAA regions within the CTA scans. During the prediction phase, the deep learning architecture demonstrates exceptional speed, requiring $17~\pm ~0.02$ milliseconds per frame to generate the final segmented output. Building upon this work, we included the application of Non-Uniform Rational B-Splines (NURBS) to enhance the segmentation process. This advancement is essential in addressing the critical need for clinical accuracy in medical image segmentation. NURBS enables the creation of continuous curves that seamlessly conform to the intricate contours of anatomical structures, offering a significant improvement in segmentation accuracy. Through the integration of advanced deep learning architectures and the precision of NURBS for segmentation refinement, coupled with the fast processing time and accurate segmentation, the the proposed model represents a promising clinical tool that can be used in the clinical management of AAAs.