End-to-End Autonomous Recursive Arborescence Deformable Flow and Non-Linear Hemodynamics for Patient-Specific Coronary Centerline Extraction
This study addresses the limitations of coronary centerline extraction, including severed bifurcations, non-anatomical shortcuts, and ischemia underestimation by linear flow models. We propose an end-to-end framework that decouples geometric tree generation from nonlinear hemodynamics. Methodologically, we introduce autonomous ostium localization to eliminate seed dependence, alongside a recursive tree state machine and Tree-NMS to ensure topological connectivity. Furthermore, a 3D feature pyramid deformable-flow architecture is integrated with a Picard-iterative nonlinear Kirchhoff solver to accurately capture functional ischemia. Experimental results demonstrate a mean localization error of 7.63 mm and mass conservation residuals reaching machine precision. Crucially, the proposed method successfully identifies ischemic lesions missed by linear models, significantly enhancing diagnostic sensitivity.