Prognostication of the abdominal aortic aneurysm with a novel three-dimensional ultrasonographic analysis system and its comparison with computed tomography

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Self Introduction An abdominal aortic aneurysm is a life-threatening condition and the risk of rupture is higher with the increased maximum diameter (Dmax) and expansion rate. Therefore, AAAs require regular monitoring of Dmax. The most commonly used imaging technique for measuring AAA size is two-dimensional ultrasonography (2-D US), closely followed by computed tomography (CT). Purpose : This study sought to evaluate the accuracy of a novel semi-automated 3-D ultrasonography (3-D US) system and its comparison CT as a reference. Methods : A total of 66 patients with abdominal aortic aneurysm were prospectively recruited in an outpatient setting. Two-dimensional ultrasonography (2-D US) and 3-D US images were attained with a single-sweep volumetric transducer. Dmax and the vessel area of the Dmax slice were measured with 2-D US, 3-D US, and CT. The vessel, lumen, and thrombus areas of the Dmax slice were also measured using 3-D US and CT. Results : It was found that the Dmax values from the 3-D US demonstrate better agreement (R2 = 0.971) with the CT values than with the 2-D US values (R2 = 0.929). Overall, 2-D US underestimated Dmax compared with 3-D US (30.8 ± 13.1mm vs. 34.4 ± 11.6 mm). The vessel, lumen, and thrombus areas all demonstrated better agreement with CT than with 2-D US (R2 = 0.988 vs. 0.961 for the vessel, R2 = 0.879 vs. 0.829 for the lumen, and R2 = 0.963 vs. 0.849 for the thrombus). Conclusion : Our study concludes that our novel semi-automated 3-D US analysis system provides more accurate Dmax values and volumetric data as compared to the 2-D US. The application of the semi-automated 3-D US analysis system in an abdominal aorta assessment is easy and accurate. Abstract Figure. Comparison of AAA on three modalities

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Feasibility and accuracy of a novel automated three-dimensional ultrasonographic analysis system for abdominal aortic aneurysm: comparison with two-dimensional ultrasonography and computed tomography

Cardiovascular Ultrasound ◽

10.1186/s12947-020-00207-0 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

In-Jeong Cho ◽

Jinyong Lee ◽

Jinki Park ◽

Sang-Eun Lee ◽

Chul-Min Ahn ◽

...

Keyword(s):

Computed Tomography ◽

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Three Dimensional ◽

Two Dimensional ◽

Abdominal Aortic ◽

Analysis System

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Vascular Deformation Mapping of Abdominal Aortic Aneurysm

Tomography ◽

10.3390/tomography7020017 ◽

2021 ◽

Vol 7 (2) ◽

pp. 189-201

Author(s):

Drew J. Braet ◽

Jonathan Eliason ◽

Yunus Ahmed ◽

Pieter A. J. van Bakel ◽

Jiayang Zhong ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Complex Disease ◽

Endovascular Aneurysm Repair ◽

Three Dimensional ◽

Aortic Aneurysms ◽

Maximum Diameter ◽

Abdominal Aortic ◽

Risk Of Rupture ◽

Imaging Surveillance

Abdominal aortic aneurysm (AAA) is a complex disease that requires regular imaging surveillance to monitor for aneurysm stability. Current imaging surveillance techniques use maximum diameter, often assessed by computed tomography angiography (CTA), to assess risk of rupture and determine candidacy for operative repair. However, maximum diameter measurements can be variable, do not reliably predict rupture risk and future AAA growth, and may be an oversimplification of complex AAA anatomy. Vascular deformation mapping (VDM) is a recently described technique that uses deformable image registration to quantify three-dimensional changes in aortic wall geometry, which has been previously used to quantify three-dimensional (3D) growth in thoracic aortic aneurysms, but the feasibility of the VDM technique for measuring 3D growth in AAA has not yet been studied. Seven patients with infra-renal AAAs were identified and VDM was used to identify three-dimensional maps of AAA growth. In the present study, we demonstrate that VDM is able to successfully identify and quantify 3D growth (and the lack thereof) in AAAs that is not apparent from maximum diameter. Furthermore, VDM can be used to quantify growth of the excluded aneurysm sac after endovascular aneurysm repair (EVAR). VDM may be a useful adjunct for surgical planning and appears to be a sensitive modality for detecting regional growth of AAAs.

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Maximum Diameter of Native Abdominal Aortic Aneurysm Measured by Angio-Computed Tomography

Aorta ◽

10.12945/j.aorta.2015.14-059 ◽

2015 ◽

Vol 03 (02) ◽

pp. 47-55 ◽

Cited By ~ 6

Author(s):

Caroline Mora ◽

Claude Marcus ◽

Coralie Barbe ◽

Fiona Ecarnot ◽

Anne Long

Keyword(s):

Computed Tomography ◽

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Weighted Kappa ◽

Maximum Diameter ◽

Clinical Decisions ◽

Diameter Measurement ◽

Double Blind ◽

Automated Method ◽

Abdominal Aortic

Background: Computed tomography angiography (CTA) is the reference technique for the measurement of native maximum abdominal aortic aneurysm (AAA) diameter when surgery is being considered. However, there is a wide choice available for the methodology of maximum AAA diameter measurement on CTA, and to date, no consensus has been reached on which method is best. We analyzed clinical decisions based on these various measures of native maximum AAA diameter with CTA, then analyzed their reproducibility and identified the method of measurement yielding the highest agreement in terms of patient management. Materials and Methods: Three sets of measures in 46 native AAA were obtained, double-blind by three radiologists (J, S, V) on orthogonal planes, curved multiplanar reconstructions, and semi-automated-software, based on the AAA-lumen centerline. From each set, the clinical decision was recorded as follows: "Follow-up" (if all diameters <50 mm), "ambiguous" (if at least one diameter <50 mm AND at least one ≥50 mm) or "Surgery " (if all diameters ≥50 mm). Intra- and interobserver agreements in clinical decisions were compared using the weighted Kappa coefficient. Results: Clinical decisions varied according to the measurement sets used by each observer, and according to intra and interobserver (lecture#1) reproducibility. Based on the first reading of each observer, the number of AAA proposed for surgery ranged from 11 to 24 for J, 5 to 20 for S, and 15 to 23 for V. The rate of AAAs classified as "ambiguous" varied from 11% (5/46) to 37% (17/46).The semi-automated method yielded very good intraand interobserver agreements in clinical decisions in all comparisons (Kappa range 0.83–1.00). Conclusion: The semi-automated method seems to be appropriate for native AAA maximum diameter measurement on CTA. In the absence of AAA outer-wallbased software more robust for complex AAA, clinical decisions might best be made with diameter values obtained using this technique.

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