Intracoronary Optical Coherence Tomography Image Processing and Vessel Classification Using Machine Learning

This work proposes a pixel-classification approach for vessel segmentation in x-ray angiograms. The proposal uses textural features such as anisotropic diffusion, features based on the Hessian matrix, mathematical morphology and statistics. These features are extracted from the neighborhood of each pixel. The approach also uses the ELEMENT methodology, which consists of creating a pixel-classification controlled by region-growing where the result of the classification affects further classifications of pixels. The Random Forests classifier is used to predict whether the pixel belongs to the vessel structure. The approach achieved the best accuracy in the literature (95.48%) outperforming unsupervised state-of-the-art approaches.

Optical coherence tomography angiography (OCTA) provides non-invasive visualization of retinal microvasculature, but learning robust representations remains challenging due to sparse vessel structures and strong topological constraints. Many existing self-supervised learning approaches, including masked autoencoders, are primarily designed for dense natural images and rely on uniform masking and pixel-level reconstruction, which may inadequately capture vascular geometry. We propose VAMAE, a vessel-aware masked autoencoding framework for self-supervised pretraining on OCTA images. The approach incorporates anatomically informed masking that emphasizes vessel-rich regions using vesselness and skeleton-based cues, encouraging the model to focus on vascular connectivity and branching patterns. In addition, the pretraining objective includes reconstructing multiple complementary targets, enabling the model to capture appearance, structural, and topological information. We evaluate the proposed pretraining strategy on the OCTA-500 benchmark for several vessel segmentation tasks under varying levels of supervision. The results indicate that vessel-aware masking and multi-target reconstruction provide consistent improvements over standard masked autoencoding baselines, particularly in limited-label settings, suggesting the potential of geometry-aware self-supervised learning for OCTA analysis.

The vascular network in the human body is characterized by blood vessels exhibiting drastic structural variations in radius, length, topological properties, and branching patterns. This heterogeneity, together with location-specific anatomical background variations, poses a significant challenge for robust, large-scale analysis of the entire cardiovascular system. As a result, most research has focused on narrow, isolated segments of the vascular network. While such targeted studies provide valuable insights, they inherently limit the ability to assess the systemic health and functional integrity of the vascular network as a whole. In this work, we aim to bridge this gap to advance both clinical diagnostics and our fundamental understanding of vascular physiology. We propose the task of segmenting all vessels in CT images, ranging from the largest components of the cardiovascular system to even minuscule mesenteric vessels. To this end, we introduce vesselFM-CT, the first model capable of robustly segmenting all blood vessels in 3D CT images. VesselFM-CT is trained via an iterative, multi-step process and optimizes our proposed TubeLoss loss function, effectively addressing the inherent heterogeneity of the cardiovascular system. We demonstrate that vesselFM-CT outperforms all baselines and enables automated, precise extraction of the cardiovascular system from CT images, thereby unlocking a wide range of clinical and technical perspectives, including automated disease classification and synthetic CT image generation.