Surface modeling and segmentation of the 3D airway wall in MSCT

Airway wall remodeling in asthma and chronic obstructive pulmonary disease (COPD) is a well-known indicator of the pathology. In this context, current clinical studies aim for establishing the relationship between the airway morphological structure and its function. Multislice computed tomography (MSCT) allows morphometric assessment of airways, but requires dedicated segmentation tools for clinical exploitation. While most of the existing tools are limited to cross-section measurements, this paper develops a fully 3D approach for airway wall segmentation. Such approach relies on a deformable model which is built up as a patient-specific surface model at the level of the airway lumen and deformed to reach the outer surface of the airway wall. The deformation dynamics obey a force equilibrium in a Lagrangian framework constrained by a vector field which avoids model self-intersections. The segmentation result allows a dense quantitative investigation of the airway wall thickness with a deeper insight at bronchus subdivisions than classic cross-section methods. The developed approach has been assessed both by visual inspection of 2D cross-sections, performed by two experienced radiologists on clinical data obtained with various protocols, and by using a simulated ground truth (pulmonary CT image model). The results confirmed a robust segmentation in intra-pulmonary regions with an error in the range of the MSCT image resolution and underlined the interest of the volumetric approach versus purely 2D methods.