Novel registration-based framework for CT angiography in lower legs

• Published in: Medical & biological engineering & computing Vol. 51; no. 10; pp. 1079 - 1089
• Main Authors: Peter, Roman, Malinsky, Milos, Ourednicek, Petr, Lambert, Lukas, Jan, Jiri
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-10-2013; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Algorithms; Angiography, Digital Subtraction - methods; Biomedical and Life Sciences; Biomedical engineering; Biomedical Engineering and Bioengineering; Biomedicine; Blood vessels; Computer Applications; Female; Hospitals; Human Physiology; Humans; Image Processing, Computer-Assisted - methods; Imaging; Leg - diagnostic imaging; Leg - physiology; Legs; Male; Medical imaging; Middle Aged; Movement - physiology; Original Article; Radiology; Registration; Software; Studies; Tomography; Tomography, X-Ray Computed - methods; Vein & artery diseases; Visualization; Czech Republic; Image registration; Subtraction angiography; Computed tomography; Lower legs
• ISSN: 0140-0118; 1741-0444
• DOI: 10.1007/s11517-013-1085-y

Proper subtraction and visualization of contrast-enhanced blood vessels in lower extremities using computed tomography angiography (CTA) is based on precise masking of all non-contrasted structures in the area, and it is the main prerequisite for correct diagnosis and decision on treatment for peripheral arterial occlusive disease (PAOD). Because of possible motion of patients during the CTA examination, precise elimination of non-contrasted tissues, including bones, calcifications, and soft tissue, is still very challenging for lower legs, that is, from knees to toes. We propose novel registration-based framework for detection and correction of the motion in lower legs, which typically occurs between and during CTA pre-contrast and post-contrast acquisitions. Within the framework, two registration cores are proposed as alternatives, and resulting CTA subtraction images are compared with Advanced Vessel Analysis considered one of the reference commercial tools among clinical applications for CTA of lower extremities. The CTA subtraction images of 55 patients examined for PAOD are evaluated visually by four expert observers on the Philips Extended Brilliance Workspace using four criteria assessing the overall robustness of tested methods. According to the complex evaluation, the proposed framework enabled valuable improvements of CTA examination of lower legs.