Metallic Component Preserving Algorithm Based on the Cerebral Computed Tomography Angiography in Aneurysm Surgery.

Youngjin Lee,Jina Shim,Kyu Bom Kim,Kyuseok Kim,Su Hwan Lee

doi:10.3390/diagnostics12020338

Abstract

The purpose of this study was to investigate the viability of the proposed method in preventing the loss of metallic components including the clip and coil in cerebral computed tomography angiography (CTA). Forty patients undergoing surgery for aneurysms carried metallic materials. The proposed method is based on conventional bone subtraction CTA (BS-CTA) system. Briefly, the position of metal components was determined using the threshold value and a region of interest (ROI). An appropriate threshold was used to separate the background from the target materials based on the Otsu method. A three-dimensional (3D) rendering was performed from the proposed BS-CTA data carrying the extracted target information. The accuracy of clip and coil region measured using the dice similarity coefficient (DSC) and bidirectional Hausdorff distance (HD) is reported. The metallic components of the proposed BS-CTA were significantly visualized in various patient cases. Quantitative evaluation using the proposed method is based on the mean DSC of 0.93 with a standard deviation (SD) of ±0.05 (e.g., maximum value = 0.99, minimum value = 0.75, 95% confidence interval (CI) = 0.91 to 0.95, and all p < 0.05). The mean HD was 1.50 voxels with an SD of ± 0.58 (e.g., maximum value = 5.95, minimum value = 0.12, 95% CI = 1.10 to 1.90, and all p < 0.05). The proposed method demonstrates effective segmentation of the metallic component and application to the existing conventional BS-CTA system.

Highlights

Early detection of cerebral aneurysms is most important in preventing subarachnoid hemorrhage (SAH)
This study evaluated adult patients with post-cerebral aneurysm clipping and coiling
Most of them are eliminated in BS-Computed tomography angiography (CTA) except for vascular information with contrast agents

Summary

Introduction

Detection of cerebral aneurysms is most important in preventing subarachnoid hemorrhage (SAH). Invasive three-dimensional (3D) DSA is the gold standard for detection of cerebral aneurysms. It can lead to permanent neurologic deficits in 0.12% of all patients [3] and may increase the risk of rebleeding, based on 5% to 10% false-negative results [4,5]. MRA is a non-invasive method without exposure to ionizing radiation and does not entail the use of contrast agents except in extraordinary. Diagnostics 2022, 12, 338 rebleeding, based on 5% to 10% false‐negative results [4,5]. MRA is a non‐invasive method without exposure to ionizing radiation and does not entail the use of contrast agents ex‐ ccaespets.inNexvterratohredleinssa,riyt icsasues.ceNpetvibelrethtoelmesost,iiotnisarstuesfcaecptstidbuleettoo mthoetliongasrtceafnacttims deus eretqoutihreed alnodnghsigcahnertismcaens rceoqsutsirceodmapnadrehdigwheitrhsCcaTnAco[6s,t7s]c. MRA is a non‐invasive method without exposure to ionizing radiation and does not entail the use of contrast agents ex‐ ccaespets.inNexvterratohredleinssa,riyt icsasues.ceNpetvibelrethtoelmesost,iiotnisarstuesfcaecptstidbuleettoo mthoetliongasrtceafnacttims deus eretqoutihreed alnodnghsigcahnertismcaens rceoqsutsirceodmapnadrehdigwheitrhsCcaTnAco[6s,t7s]c. ompared with CTA [6,7]

Objectives

Methods

Results