The Circle of Willis (CoW) is an important network of arteries connecting major circulations of the brain. Its vascular architecture is believed to affect the risk, severity, and clinical outcome of serious neuro-vascular diseases. However, characterizing the highly variable CoW anatomy is still a manual and time-consuming expert task. The CoW is usually imaged by two angiographic imaging modalities, magnetic resonance angiography (MRA) and computed tomography angiography (CTA), but there exist limited public datasets with annotations on CoW anatomy, especially for CTA. Therefore we organized the TopCoW Challenge in 2023 with the release of an annotated CoW dataset. The TopCoW dataset was the first public dataset with voxel-level annotations for thirteen possible CoW vessel components, enabled by virtual-reality (VR) technology. It was also the first large dataset with paired MRA and CTA from the same patients. TopCoW challenge formalized the CoW characterization problem as a multiclass anatomical segmentation task with an emphasis on topological metrics. We invited submissions worldwide for the CoW segmentation task, which attracted over 140 registered participants from four continents. The top performing teams managed to segment many CoW components to Dice scores around 90%, but with lower scores for communicating arteries and rare variants. There were also topological mistakes for predictions with high Dice scores. Additional topological analysis revealed further areas for improvement in detecting certain CoW components and matching CoW variant topology accurately. TopCoW represented a first attempt at benchmarking the CoW anatomical segmentation task for MRA and CTA, both morphologically and topologically.

Intracranial aneurysms are a commonly occurring and lifethreatening condition, affecting approximately 3.2% of the general population. Consequently, the detection of these aneurysms plays a crucial role in their management. Lesion detection involves the simultaneous localization and categorization of abnormalities within medical images. In this particular study, we employed the nnDetection framework, a selfconfiguring framework specifically designed for 3D medical object detection, to effectively detect and localize the 3D coordinates of aneurysms. To capture and extract diverse features associated with aneurysms, we utilized two modalities: TOF-MRA and structural MRI, both obtained from the ADAM dataset. The performance of our proposed deep learning model was assessed through the utilization of free-response receiver operative characteristics for evaluation purposes.

Vessel tracing by modeling vascular structures in 3D medical images with centerlines and radii can provide useful information for vascular health. Existing algorithms have been developed but there are certain persistent problems such as incomplete or inaccurate vessel tracing, especially in complicated vascular beds like the intracranial arteries. We propose here a deep learning based open curve active contour model (DOST) to trace vessels in 3D images. Initial curves were proposed from a centerline segmentation neural network. Then data-driven machine knowledge was used to predict the stretching direction and vessel radius of the initial curve, while the active contour model (as human knowledge) maintained smoothness and intensity fitness of curves. Finally, considering the nonloop topology of most vasculatures, individually traced vessels were connected into a tree topology by applying a minimum spanning tree algorithm on a global connection graph. We evaluated DOST on a Time-of-Flight (TOF) MRA intracranial artery dataset and demonstrated its superior performance over existing segmentation-based and tracking-based vessel tracing methods. In addition, DOST showed strong adaptability on different imaging modalities (CTA, MR T1 SPACE) and vascular beds (coronary arteries).