Machine learning-based automatic detection of pulmonary trunk

Pulmonary embolism is a common cardiovascular emergency with about 600,000 cases occurring annually and causing approximately 200,000 deaths in the US. CT pulmonary angiography (CTPA) has become the reference standard for PE diagnosis, but the interpretation of these large image datasets is made complex and time consuming by the intricate branching structure of the pulmonary vessels, a myriad of artifacts that may obscure or mimic PEs, and suboptimal bolus of contrast and inhomogeneities with the pulmonary arterial blood pool. To meet this challenge, several approaches for computer aided diagnosis of PE in CTPA have been proposed. However, none of these approaches is capable of detecting central PEs, distinguishing the pulmonary artery from the vein to effectively remove any false positives from the veins, and dynamically adapting to suboptimal contrast conditions associated the CTPA scans. To overcome these shortcomings, it requires highly efficient and accurate identification of the pulmonary trunk. For this very purpose, in this paper, we present a machine learning based approach for automatically detecting the pulmonary trunk. Our idea is to train a cascaded AdaBoost classifier with a large number of Haar features extracted from CTPA image samples, so that the pulmonary trunk can be automatically identified by sequentially scanning the CTPA images and classifying each encountered sub-image with the trained classifier. Our approach outperforms an existing anatomy-based approach, requiring no explicit representation of anatomical knowledge and achieving a nearly 100% accuracy tested on a large number of cases.