MRI analysis tool reveals brain artery differences missed by older software

by Mark Michaud, University of Rochester Medical Center

edited by Sadie Harley, reviewed by Robert Egan

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The brain's network of blood vessels plays a critical role in maintaining neurological health. Changes to these vessels are associated with conditions including stroke, cognitive impairment and dementia. Yet studying the brain's smallest arteries can be challenging, in part because extracting detailed measurements from MRI images often requires substantial manual work.

Researchers at University of Rochester Medicine are developing a technology called ArteryX to address this challenge. The software toolbox analyzes MRI images of the brain's arteries, allowing researchers to measure characteristics such as vessel size, length, branching and complexity.

By making this process more automated and consistent, ArteryX could help scientists investigate how changes in the brain's vascular network contribute to disease.

The technology was developed under a project led by Nasir Uddin, Ph.D., and described in a study published in Magnetic Resonance in Medicine. Abrar Faiyaz, Ph.D., a postdoctoral research associate in Uddin's lab, is the study's first author.

Addressing a challenge in brain-vessel research

MRI can produce detailed images of the brain's blood vessels, but converting those images into standardized measurements has traditionally required researchers to manually trace vessels, correct errors and identify individual arteries. The process is particularly difficult when vessels are small, closely spaced or located farther from the major arteries.

These challenges can make large studies time-consuming and introduce differences between users analyzing the same images. "ArteryX grew out of a major bottleneck in quantitative brain-vessel research," Uddin said. "We wanted to develop a more automated, reliable and standardized approach."

A more detailed picture of the vascular network

ArteryX analyzes three-dimensional time-of-flight magnetic resonance angiography (3D TOF-MRA), an MRI technique used to visualize blood vessels in the brain.

The toolbox measures several characteristics of the arterial network, including vessel length, radius, volume, surface area, branching, tortuosity (the degree to which a vessel curves and twists) and fractional dimensionality (the complexity and density of blood vessels). These measurements help scientists examine how the structure and organization of blood vessels vary between individuals and change with disease.

The researchers compared ArteryX with iCafe, an existing toolbox for cerebral artery analysis. ArteryX required approximately 10–15 minutes of processing and user interaction, compared with roughly 1.5 hours for a trained user working with iCafe. Reducing the time and manual effort required for analysis could make it more practical to study larger groups of participants and compare results across research studies.

"Developing ArteryX has been an exciting opportunity to translate advanced MRI image analysis into a practical tool for the neuroscience community," said Faiyaz. "We hope the platform will enable larger, more reproducible studies and help researchers discover new imaging biomarkers for cerebrovascular disease."

Studying cerebrovascular disease and other conditions

The researchers evaluated ArteryX using data from a cohort of people with and without cerebral small vessel disease (CSVD) from a recently completed study by Giovanni Schifitto, M.D., a neurologist at URochester Medicine. CSVD is a condition involving changes or damage to the brain's small blood vessels and is associated with stroke and cognitive impairment.

In their analysis, the researchers found that ArteryX detected several vascular differences between people with and without CSVD that iCafe did not, including changes in smaller vessels.

The findings suggest that detailed measurements of the arterial network could help researchers investigate potential biomarkers of cerebrovascular disease. The technology could also be used to study other conditions in which changes to blood vessels may contribute to neurological disease, including stroke, Alzheimer's disease and vascular dementia.

Next steps for the technology

"We are working to make ArteryX more automated, faster and more comprehensive," Uddin said. "Ultimately, our goal is to make quantitative brain-vessel analysis more accessible, reproducible and useful for research and, eventually, clinical care."

The team is exploring a potential way to combine information about the structure of brain arteries with information about blood flow, which could eventually provide a more complete picture of vascular health.

Before ArteryX could be used in clinical care, it would require extensive validation across different MRI scanners and patient populations. Researchers would also need evidence that its measurements can meaningfully improve risk assessment or disease monitoring.

For now, ArteryX is primarily an academic research tool. A version is freely available for academic use to encourage reproducibility and broader adoption. The researchers are interested in potential collaborations with medical imaging and technology companies and, if future studies demonstrate clear clinical value, potential commercialization or integration with existing imaging platforms.

By reducing the time and variability involved in analyzing brain blood vessels, ArteryX offers a new approach to studying the relationship between vascular structure and neurological disease.

More information

Abrar Faiyaz et al., ArteryX : A Reliable End‐To‐End Toolbox for Standardized Intracranial Artery Feature Extraction From 3D TOF ‐ MRA, Magnetic Resonance in Medicine (2026). DOI: 10.1002/mrm.70564

Key medical concepts

Cerebral Small Vessel Diseases

Clinical categories

NeurologyDiagnostic radiology Provided by University of Rochester Medical Center Who's behind this story?

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