Methods and systems are described for assessing a vessel obstruction. The methods and systems obtain a volumetric image dataset for a target organ that includes a vessel of interest, extract an axial trajectory extending along of a vessel of interest (VOI) within the volumetric image dataset, and create a three-dimensional (3D) multi-planer reformatted (MPR) image based on the volumetric image dataset and the axial trajectory of the VOI. The methods and systems also extract a VOI parameter from the MPR utilizing a machine learning-based vessel obstruction assessment (VOA) model. Methods and systems are also described for implementing a prediction phase to perform at least one of i) detecting plaque type, ii) classifying anatomical severity of vessel blockage, and/or iii) classifying a hemodynamic severity of vessel obstructions within an unseen portion of the volumetric image data set.