Abstract

BackgroundIntracranial aneurysm is a common type of cerebrovascular disease with a risk of devastating subarachnoid hemorrhage if it is ruptured. Accurate computer-aided detection of aneurysms can help doctors improve the diagnostic accuracy, and it is very helpful in reducing the risk of subarachnoid hemorrhage. Aneurysms are detected in 2D or 3D images from different modalities. 3D images can provide more vascular information than 2D images, and it is more difficult to detect. The detection performance of 2D images is related to the angle of view; it may take several angles to determine the aneurysm. As the gold standard for the diagnosis of vascular diseases, the detection on digital subtraction angiography (DSA) has more clinical value than other modalities. In this study, we proposed an adaptive multiscale filter to detect intracranial aneurysms on 3D-DSA.MethodsAdaptive aneurysm detection consists of three parts. The first part is a filter based on Hessian matrix eigenvalues, whose parameters are automatically obtained by Bayesian optimization. The second part is aneurysm extraction based on region growth and adaptive thresholding. The third part is the iterative detection strategy for multiple aneurysms.ResultsThe proposed method was quantitatively evaluated on data sets of 145 patients. The results showed a detection precision of 94.6%, and a sensitivity of 96.4% with a false-positive rate of 6.2%. Among aneurysms smaller than 5 mm, 93.9% were found. Compared with aneurysm detection on 2D-DSA, automatic detection on 3D-DSA can effectively reduce the misdiagnosis rate and obtain more accurate detection results. Compared with other modalities detection, we also get similar or better detection performance.ConclusionsThe experimental results show that the proposed method is stable and reliable for aneurysm detection, which provides an option for doctors to accurately diagnose aneurysms.

Highlights

  • Intracranial aneurysm is a common type of cerebrovascular disease with a risk of devastating subarachnoid hemorrhage if it is ruptured

  • Subarachnoid hemorrhage (SAH), which results from the rupture of an intracranial aneurysm, is a devastating event associated with high rates of mortality (40–50%) and morbidity, while only 40% of SAH patients recover to reach independent status [3, 4]

  • We proposed an automatic detection of intracranial aneurysms on 3D-digital subtraction angiography (DSA) based on a Bayesian optimized filter

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Summary

Introduction

Intracranial aneurysm is a common type of cerebrovascular disease with a risk of devastating subarachnoid hemorrhage if it is ruptured. Subarachnoid hemorrhage (SAH), which results from the rupture of an intracranial aneurysm, is a devastating event associated with high rates of mortality (40–50%) and morbidity, while only 40% of SAH patients recover to reach independent status [3, 4]. Image modalities that are used in aneurysm diagnosis usually include computed tomography angiography (CTA), magnetic resonance angiography (MRA), and digital subtraction angiography (DSA). These imaging techniques can adequately show the location, size and shape of aneurysms and help doctors make reasonable treatment plans [7]. For some small intracranial aneurysms, CTA and MRA diagnosis performance is not as good as DSA, which has been used as the ground truth for aneurysm diagnosis [8, 9]

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