Feasibility of capturing vessel expansion with 4D-CTA: Phantom study to determine reproducibility, spatial and temporal resolution.

Abstract

Dynamic Computed Tomography Angiography (4D CTA) has the potential of providing insight into the biomechanical properties of the vessel wall, by capturing motion of the vessel wall. For vascular pathologies, like intracranial aneurysms, this could potentially refine diagnosis, prognosis, and treatment decision-making. The objective of this research is to determine the feasibility of a 4D CTA scanner for accurately measuring harmonic diameter changes in an in-vitro simulated vessel. A silicon tube was exposed to a simulated heartbeat. Simulated heart rates between 40 and 100 beats-per-minute (bpm) were tested and the flow amplitude was varied, resulting in various changes of tube diameter. A 320-detector row CT system with ECG-gating captured three consecutive cycles of expansion. Image registration was used to calculate the diameter change. A vascular echography set-up was used as a reference, using a 9MHz linear array transducer. The reproducibility of 4D CTA was represented by the Pearson correlation (r) between the three consecutive diameter change patterns, captured by 4D CTA. The peak value similarity (pvs) was calculated between the 4D CTA and US measurements for increasing frequencies and was chosen as a measure of temporal resolution. Spatial resolution was represented by the Sum of the Relative Percentual Difference (SRPD) between 4D CTA and US diameter change patterns for increasing amplitudes. The reproducibility of 4D CTA measurements was good (r ≥ 0.9) if the diameter change was larger than 0.3mm, moderate (0.7 ≤ r<0.9) if the diameter change was between 0.1 and 0.3mm, and low (r<0.7) if the diameter change was smaller than 0.1mm. Regarding the temporal resolution, the amplitude of 4D CTA was similar to the US measurements (pvs ≥ 90%) for the frequencies of 40 and 50bpm. Frequencies between 60 and 80bpm result in a moderate similarity (70% ≤ pvs<90%). A low similarity (pvs<70%) is observed for 90 and 100bpm. Regarding the spatial resolution, diameter changes above 0.30mm result in SRPDs consistently below 50%. In a phantom setting, 4D CTA can be used to reliably capture reproducible tube diameter changes exceeding 0.30mm. Low pulsation frequencies (40 or 50bpm) provide an accurate measurement of the maximum tube diameter change.