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ImageCAS-X: a dataset and benchmark for coronary artery segmentation and centerline extraction in coronary CT angiography

Kit M. Bransby Esther {\O}ksnebjerg Kristoffer Kj{\ae}r Jacob Kirkeby Yasmin El Youssef A\"ida Jim\'enez Philip R. Pedersson Martina C. de Knegt Klaus F. Kofoed Rasmus R. Paulsen
Sep 2026
Artificial Intelligence Computer Vision

Abstract

Accurate segmentation of the coronary vessel lumen is a prerequisite for quantitative assessment of atherosclerotic plaque and perivascular adipose tissue in coronary computed tomography angiography (CCTA). Cardiologists rely on semi-automated methods for this task because manual vessel tracing and segmentation are labour-intensive. Although many automated methods have been proposed, their validation remains limited by the lack of large, high-quality publicly available datasets. We provide a new dataset of voxel-wise annotations of the vessel lumen and coronary segments, alongside centerlines, and mesh surfaces for 800 scans from the publicly available ImageCAS dataset. Using this dataset, we benchmark established lumen segmentation methods against inter-observer variability, stratifying performance by disease, image quality, coronary dominance, coronary segment, vessel diameter, and lumen attenuation. These labels allow segmentation accuracy to be described in anatomical and clinical context rather than reported as a single aggregate score. The dataset supports the development and validation of methods for lumen segmentation, plaque and perivascular quantification, and haemodynamic modelling.

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