Diaphragm border detection in coronary X-ray angiographies: New method and applications

X-ray angiography is widely used in cardiac disease diagnosis during or prior to intravascular interventions. The diaphragm motion and the heart beating induce gray-level changes, which are one of the main obstacles in quantitative analysis of myocardial perfusion. In this paper we focus on detecting the diaphragm border in both single images or whole X-ray angiography sequences. We show that the proposed method outperforms state of the art approaches. We extend a previous publicly available data set, adding new ground truth data. We also compose another set of more challenging images, thus having two separate data sets of increasing difficulty. Finally, we show three applications of our method: (1) a strategy to reduce false positives in vessel enhanced images; (2) a digital diaphragm removal algorithm; (3) an improvement in Myocardial Blush Grade semi-automatic estimation.