Claude Kauffmann1, Frédéric Douane2, Eric Therasse1, Simon Lessard3, Stephane Elkouri4, Patrick Gilbert2, Nathalie Beaudoin4, Marcus Pfister5, Jean François Blair4, Gilles Soulez6. 1. Department of Radiology, University of Montreal Hospital Center, Montreal, Quebec, Canada; Department of Radiology, Radio-Oncology and Nuclear Medicine and Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada; University of Montreal Hospital Research Center, Montreal, Quebec, Canada. 2. Department of Radiology, University of Montreal Hospital Center, Montreal, Quebec, Canada. 3. University of Montreal Hospital Research Center, Montreal, Quebec, Canada. 4. Department of Surgery, University of Montreal Hospital Center, Montreal, Quebec, Canada. 5. Siemens, Healthcare Sector, Forchheim, Germany. 6. Department of Radiology, University of Montreal Hospital Center, Montreal, Quebec, Canada; Department of Radiology, Radio-Oncology and Nuclear Medicine and Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada; University of Montreal Hospital Research Center, Montreal, Quebec, Canada. Electronic address: gilles.soulez.chum@ssss.gouv.qc.ca.
Abstract
PURPOSE: To evaluate the accuracy and source of errors using a two-dimensional (2D)/three-dimensional (3D) fusion road map for endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm. MATERIALS AND METHODS: A rigid 2D/3D road map was tested in 16 patients undergoing EVAR. After 3D/3D manual registration of preoperative multidetector computed tomography (CT) and cone beam CT, abdominal aortic aneurysm outlines were overlaid on live fluoroscopy/digital subtraction angiography (DSA). Patient motion was evaluated using bone landmarks. The misregistration of renal and internal iliac arteries were estimated by 3 readers along head-feet and right-left coordinates (z-axis and x-axis, respectively) before and after bone and DSA corrections centered on the lowest renal artery. Iliac deformation was evaluated by comparing centerlines before and during intervention. A score of clinical added value was estimated as high (z-axis < 3 mm), good (3 mm ≤ z-axis ≤ 5 mm), and low (z-axis > 5 mm). Interobserver reproducibility was calculated by the intraclass correlation coefficient. RESULTS: The lowest renal artery misregistration was estimated at x-axis = 10.6 mm ± 11.1 and z-axis = 7.4 mm ± 5.3 before correction and at x-axis = 3.5 mm ± 2.5 and z-axis = 4.6 mm ± 3.7 after bone correction (P = .08), and at 0 after DSA correction (P < .001). After DSA correction, residual misregistration on the contralateral renal artery was estimated at x-axis = 2.4 mm ± 2.0 and z-axis = 2.2 mm ± 2.0. Score of clinical added value was low (n = 11), good (n= 0), and high (n= 5) before correction and low (n = 5), good (n = 4), and high (n = 7) after bone correction. Interobserver intraclass correlation coefficient for misregistration measurements was estimated at 0.99. Patient motion before stent graft delivery was estimated at x-axis = 8 mm ± 5.8 and z-axis = 3.0 mm ± 2.7. The internal iliac artery misregistration measurements were estimated at x-axis = 6.1 mm ± 3.5 and z-axis = 5.6 mm ± 4.0, and iliac centerline deformation was estimated at 38.3 mm ± 15.6. CONCLUSIONS: Rigid registration is feasible and fairly accurate. Only a partial reduction of vascular misregistration was observed after bone correction; minimal DSA acquisition is still required.
PURPOSE: To evaluate the accuracy and source of errors using a two-dimensional (2D)/three-dimensional (3D) fusion road map for endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm. MATERIALS AND METHODS: A rigid 2D/3D road map was tested in 16 patients undergoing EVAR. After 3D/3D manual registration of preoperative multidetector computed tomography (CT) and cone beam CT, abdominal aortic aneurysm outlines were overlaid on live fluoroscopy/digital subtraction angiography (DSA). Patient motion was evaluated using bone landmarks. The misregistration of renal and internal iliac arteries were estimated by 3 readers along head-feet and right-left coordinates (z-axis and x-axis, respectively) before and after bone and DSA corrections centered on the lowest renal artery. Iliac deformation was evaluated by comparing centerlines before and during intervention. A score of clinical added value was estimated as high (z-axis < 3 mm), good (3 mm ≤ z-axis ≤ 5 mm), and low (z-axis > 5 mm). Interobserver reproducibility was calculated by the intraclass correlation coefficient. RESULTS: The lowest renal artery misregistration was estimated at x-axis = 10.6 mm ± 11.1 and z-axis = 7.4 mm ± 5.3 before correction and at x-axis = 3.5 mm ± 2.5 and z-axis = 4.6 mm ± 3.7 after bone correction (P = .08), and at 0 after DSA correction (P < .001). After DSA correction, residual misregistration on the contralateral renal artery was estimated at x-axis = 2.4 mm ± 2.0 and z-axis = 2.2 mm ± 2.0. Score of clinical added value was low (n = 11), good (n= 0), and high (n= 5) before correction and low (n = 5), good (n = 4), and high (n = 7) after bone correction. Interobserver intraclass correlation coefficient for misregistration measurements was estimated at 0.99. Patient motion before stent graft delivery was estimated at x-axis = 8 mm ± 5.8 and z-axis = 3.0 mm ± 2.7. The internal iliac artery misregistration measurements were estimated at x-axis = 6.1 mm ± 3.5 and z-axis = 5.6 mm ± 4.0, and iliac centerline deformation was estimated at 38.3 mm ± 15.6. CONCLUSIONS: Rigid registration is feasible and fairly accurate. Only a partial reduction of vascular misregistration was observed after bone correction; minimal DSA acquisition is still required.
Authors: Katharina Breininger; Moritz Hanika; Mareike Weule; Markus Kowarschik; Marcus Pfister; Andreas Maier Journal: Int J Comput Assist Radiol Surg Date: 2019-08-22 Impact factor: 2.924
Authors: Marloes M Jansen; Merel van der Stelt; Stefan P M Smorenburg; Cornelis H Slump; Joost A van Herwaarden; Constantijn E V B Hazenberg Journal: Quant Imaging Med Surg Date: 2021-09
Authors: Sabrina A N Doelare; Stefan P M Smorenburg; Theodorus G van Schaik; Jan D Blankensteijn; Willem Wisselink; Johanna H Nederhoed; Rutger J Lely; Arjan W J Hoksbergen; Kak Khee Yeung Journal: J Endovasc Ther Date: 2020-09-23 Impact factor: 3.487