The automated analysis of the aortic vessel tree (AVT) from computed tomography angiography (CTA) holds immense clinical potential, but its development has been impeded by a lack of shared, high-quality data. We launched the SEG.A. challenge to catalyze progress in this field by introducing a large, publicly available, multi-institutional dataset for AVT segmentation. The challenge benchmarked automated algorithms on a hidden test set, with subsequent optional tasks in surface meshing for computational simulations. Our findings reveal a clear convergence on deep learning methodologies, with 3D U-Net architectures dominating the top submissions. A key result was that an ensemble of the highest-ranking algorithms significantly outperformed individual models, highlighting the benefits of model fusion. Performance was strongly linked to algorithmic design, particularly the use of customized post-processing steps, and the characteristics of the training data. This initiative not only establishes a new performance benchmark but also provides a lasting resource to drive future innovation toward robust, clinically translatable tools.
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