ITKv5 can now wrap any user-developed module into a pip-installable package that has an intuitive, pythonic interface.
A great example is the MinimalPathExtraction module that is featured in this post.
To find centerline paths in 2D or 3D vessel or tube structures in any imaging modality, install the package with:
python -m pip install itk-minimalpathextraction
Given start and end points, this algorithm finds the a minimal path defined a Fast Marching arrival function based on the image contents.
Centerline path extracted from a vessel. From “Fast Marching Minimal Path Extraction in ITK”, Mueller D., The Insight Journal - 2008 January - June. http://hdl.handle.net/1926/1332.