# A topology-preserving three-stage framework for fully-connected coronary artery extraction

arXiv: https://arxiv.org/abs/2504.01597 · HTML: https://mlsanity.com/paper/2504.01597/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 13 of its 36 references that are in the map.
- First posted on arXiv 2 Apr 2025.

## Builds on (most cited first, 13 of 13)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [clDice -- A Novel Topology-Preserving Loss Function for Tubular Structure Segmentation](https://mlsanity.com/paper/2003.07311/) (2020)
- [NeRP: Implicit Neural Representation Learning with Prior Embedding for Sparsely Sampled Image Reconstruction](https://mlsanity.com/paper/2108.10991/) (2021)
- [Implicit Neural Representation in Medical Imaging: A Comparative Survey](https://mlsanity.com/paper/2307.16142/) (2023)
- [Dynamic CT Reconstruction from Limited Views with Implicit Neural Representations and Parametric Motion Fields](https://mlsanity.com/paper/2104.11745/) (2021)
- [ImageCAS: A Large-Scale Dataset and Benchmark for Coronary Artery Segmentation based on Computed Tomography Angiography Images](https://mlsanity.com/paper/2211.01607/) (2022)
- [CS2-Net: Deep Learning Segmentation of Curvilinear Structures in Medical Imaging](https://mlsanity.com/paper/2010.07486/) (2020)
- [Deep Forest](https://mlsanity.com/paper/1702.08835/) (2017)
- [Graph Convolutional Networks for Coronary Artery Segmentation in Cardiac CT Angiography](https://mlsanity.com/paper/1908.05343/) (2019)
- [TopNet: Topology Preserving Metric Learning for Vessel Tree Reconstruction and Labelling](https://mlsanity.com/paper/2009.08674/) (2020)
- [VSR-Net: Vessel-like Structure Rehabilitation Network with Graph Clustering](https://mlsanity.com/paper/2312.13116/) (2023)
- [Binary segmentation of medical images using implicit spline representations and deep learning](https://mlsanity.com/paper/2102.12759/) (2021)
- [3DGR-CAR: Coronary artery reconstruction from ultra-sparse 2D X-ray views with a 3D Gaussians representation](https://mlsanity.com/paper/2410.00404/) (2024)

## Built on by (most cited first, 3 of 3)

- [ImageCAS-X: a dataset and benchmark for coronary artery segmentation and centerline extraction in coronary CT angiography](https://mlsanity.com/paper/2608.30404/) (2026)
- [Widest-Path Reachability Fields for Connectivity-Preserving Slender Structure Segmentation](https://mlsanity.com/paper/2607.07123/) (2026)
- [End-to-End Autonomous Recursive Arborescence Deformable Flow and Non-Linear Hemodynamics for Patient-Specific Coronary Centerline Extraction](https://mlsanity.com/paper/2610.05900/) (2026)

## Abstract (arXiv)

Coronary artery extraction is a crucial prerequisite for computer-aided diagnosis of coronary artery disease. Accurately extracting the complete coronary tree remains challenging due to several factors, including presence of thin distal vessels, tortuous topological structures, and insufficient contrast. These issues often result in over-segmentation and under-segmentation in current segmentation methods. To address these challenges, we propose a topology-preserving three-stage framework for fully-connected coronary artery extraction. This framework includes vessel segmentation, centerline reconnection, and missing vessel reconstruction. First, we introduce a new centerline enhanced loss in the segmentation process. Second, for the broken vessel segments, we further propose a regularized walk algorithm to integrate distance, probabilities predicted by a centerline classifier, and directional cosine similarity, for reconnecting the centerlines. Third, we apply implicit neural representation and implicit modeling, to reconstruct the geometric model of the missing vessels. Experimental results show that our proposed framework outperforms existing methods, achieving Dice scores of 88.53% and 85.07%, with Hausdorff Distances (HD) of 1.07mm and 1.63mm on ASOCA and PDSCA datasets, respectively. Code will be available at https://github.com/YH-Qiu/CorSegRec.