CAD scheme for detection of intracranial aneurysms in MRA based on 3D analysis of vessel skeletons and enhanced aneurysms

We have developed a computer-aided diagnostic (CAD) scheme for detection of unruptured intracranial aneurysms in magnetic resonance angiography (MRA) based on findings of short branches in vessel skeletons, and a three-dimensional (3D) selective enhancement filter for dots (aneurysms). Fifty-three cases with 61 unruptured aneurysms and 62 non-aneurysm cases were tested in this study. The Isotropic 3D MRA images with 400 × 400 × 128 voxels (a voxel size of 0.5 mm) were processed by use of the dot enhancement filter. The initial candidates were identified not only on the dot-enhanced images by use of a multiple gray-level thresholding technique, but also on the vessel skeletons by finding short branches on parent skeletons, which can indicate a high likelihood of small aneurysms. All candidates were classified into four categories of candidates according to effective diameter and local structure of the vessel skeleton. In each category, a number of false positives were removed by use of two rule-based schemes and by linear discriminant analysis on localized image features related to gray level and morphology. Our CAD scheme achieved a sensitivity of 97% with 5.0 false positives per patient by use of a leave-one-out-by-patient test method. This CAD system may be useful in assisting radiologists in the detection of small intracranial aneurysms as well as medium-size aneurysms in MRA.