Vascular Deformation Mapping for CT Surveillance of Thoracic Aortic Aneurysm Growth
Background Aortic diameter measurements in patients with a thoracic aortic aneurysm (TAA) show wide variation. There is no technique to quantify aortic growth in a three-dimensional (3D) manner. Purpose To validate a CT-based technique for quantification of 3D growth based on deformable registration...
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| Published in: | Radiology Vol. 302; no. 1; pp. 218 - 225 |
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| Main Authors: | , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Radiological Society of North America
01-01-2022
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Background Aortic diameter measurements in patients with a thoracic aortic aneurysm (TAA) show wide variation. There is no technique to quantify aortic growth in a three-dimensional (3D) manner. Purpose To validate a CT-based technique for quantification of 3D growth based on deformable registration in patients with TAA. Materials and Methods Patients with ascending and descending TAA with two or more CT angiography studies between 2006 and 2020 were retrospectively identified. The 3D aortic growth was quantified using vascular deformation mapping (VDM), a technique that uses deformable registration to warp a mesh constructed from baseline aortic anatomy. Growth assessments between VDM and clinical CT diameter measurements were compared. Aortic growth was quantified as the ratio of change in surface area at each mesh element (area ratio). Manual segmentations were performed by independent raters to assess interrater reproducibility. Registration error was assessed using manually placed landmarks. Agreement between VDM and clinical diameter measurements was assessed using Pearson correlation and Cohen κ coefficients. Results A total of 38 patients (68 surveillance intervals) were evaluated (mean age, 69 years ± 9 [standard deviation]; 21 women), with TAA involving the ascending aorta (
= 26), descending aorta (
= 10), or both (
= 2). VDM was technically successful in 35 of 38 (92%) patients and 58 of 68 intervals (85%). Median registration error was 0.77 mm (interquartile range, 0.54-1.10 mm). Interrater agreement was high for aortic segmentation (Dice similarity coefficient = 0.97 ± 0.02) and VDM-derived area ratio (bias = 0.0, limits of agreement: -0.03 to 0.03). There was strong agreement (
= 0.85,
< .001) between peak area ratio values and diameter change. VDM detected growth in 14 of 58 (24%) intervals. VDM revealed growth outside the maximally dilated segment in six of 14 (36%) growth intervals, none of which were detected with diameter measurements. Conclusion Vascular deformation mapping provided reliable and comprehensive quantitative assessment of three-dimensional aortic growth and growth patterns in patients with thoracic aortic aneurysms undergoing CT surveillance. Published under a CC BY 4.0 license
See also the editorial by Wieben in this issue. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Author contributions: Guarantor of integrity of entire study, N.S.B.; study concepts/study design or data acquisition or data analysis/interpretation, all authors; manuscript drafting or manuscript revision for important intellectual content, all authors; approval of final version of submitted manuscript, all authors; agrees to ensure any questions related to the work are appropriately resolved, all authors; literature research, N.S.B., J.Z., B.D.R., C.R.H.; clinical studies, N.S.B., I.B.H., T.M.J.v.B., H.J.P.; statistical analysis, N.S.B., Z.B., J.Z., G.E.C., C.R.H.; and manuscript editing, N.S.B., Z.B., J.Z., I.B.H., T.M.J.v.B., H.J.P., B.D.R., G.E.C., C.R.H. |
| ISSN: | 0033-8419 1527-1315 |
| DOI: | 10.1148/radiol.2021210658 |