With the development of medical computer-aided diagnostic systems, pulmonary artery-vein(A/V) separation plays a crucial role in assisting doctors in preoperative planning for lung cancer surgery. However, distinguishing arterial from venous irrigation in chest CT images remains a challenge due to the similarity and complex structure of the arteries and veins. We propose a novel method for automatic separation of pulmonary arteries and veins from chest CT images. The method consists of three parts. First, global connection information and local feature information are used to construct a complete topological tree and ensure the continuity of vessel reconstruction. Second, the Twin-Pipe network proposed can automatically learn the differences between arteries and veins at different levels to reduce classification errors caused by changes in terminal vessel characteristics. Finally, the topology optimizer considers interbranch and intrabranch topological relationships to maintain spatial consistency to avoid the misclassification of A/V irrigations. We validate the performance of the method on chest CT images. Compared with manual classification, the proposed method achieves an average accuracy of 96.2% on noncontrast chest CT. In addition, the method has been proven to have good generalization, that is, the accuracies of 93.8% and 94.8% are obtained for CT scans from other devices and other modes, respectively. The result of pulmonary artery-vein obtained by the proposed method can provide better assistance for preoperative planning of lung cancer surgery.
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