Flexible mask subtraction for digital angiography.

A flexible-mask algorithm that effectively provides correction for motion artifacts and gray-level variations in digital subtraction angiography (DSA) images is presented. The algorithm makes use of a flexible local registration of the mask with the live image to minimize the main distortions caused by the complex motion of the heart, namely spatial translation, rotation, and nonisotropic scaling. It also reduces the gray-level variations caused by the diffusion of the contrast medium into parts of the heart other than the arteries. It is concluded from experiments on X-ray coronary angiograms that when the background near the arteries is rugged or provides significant interference, flexible mask subtraction offers important improvements in quantitative estimates of the sizes of the arteries. In all the X-ray images used in the experiments, the precision of the method was at the 0.1-pixel level. The computation is extensive. However, some improvements can be achieved by doing the subtraction only at the coronary arteries and the immediate neighborhood instead of the whole image. The algorithm lends itself to implementation by parallel-structured hardware.