Abstract
A significant proportion of the adult population worldwide suffers from cerebral aneurysms. If left untreated, aneurysms may rupture and lead to fatal massive internal bleeding. On the other hand, treatment of aneurysms also involve significant risks. It is desirable, therefore, to have an objective tool that can be used to predict the risk of rupture and assist in surgical decision for operating on the aneurysms. Currently, such decisions are made mostly based on medical expertise of the healthcare team. In this paper, we investigate the possibility of using machine learning algorithms to predict rupture risk of vertebral artery fusiform aneurysms based on geometric features of the blood vessels surrounding but excluding the aneurysm. For each of the aneurysm images (12 ruptured and 25 unruptured), the vessel is segmented into distal and proximal parts by cross-sectional area and 382 non-aneurysm-related geometric features extracted. The decision tree model using two of the features (standard deviation of eccentricity of proximal vessel, and diameter at the distal endpoint) achieved 83.8% classification accuracy. Additionally, with support vector machine and logistic regression, we also achieved 83.8% accuracy with another set of two features (ratio of mean curvature between distal and proximal parts, and diameter at the distal endpoint). Combining the aforementioned three features with integration of curvature of proximal vessel and also ratio of mean cross-sectional area between distal and proximal parts, these models achieve an impressive 94.6% accuracy. These results strongly suggest the usefulness of geometric features in predicting the risk of rupture.
Highlights
IntroductionAlmost 500 000 deaths are caused by cerebral aneurysms worldwide [1]. Aneurysms, which occur upon pathological dilation of blood vessel and weakening of the vessel wall, may grow and rupture without proper treatment [2,3,4]
Each year, almost 500 000 deaths are caused by cerebral aneurysms worldwide [1]
Previous studies on haemodynamics of aneurysms have found that the parent vessel of the aneurysm is strongly associated with haemodynamics characteristics, namely, curved parent vessels result in adverse haemodynamics [6,7]
Summary
Almost 500 000 deaths are caused by cerebral aneurysms worldwide [1]. Aneurysms, which occur upon pathological dilation of blood vessel and weakening of the vessel wall, may grow and rupture without proper treatment [2,3,4]. Previous studies on haemodynamics of aneurysms have found that the parent vessel of the aneurysm is strongly associated with haemodynamics characteristics, namely, curved parent vessels result in adverse haemodynamics [6,7]. This in turn contributes to unstable and complex flow patterns within and near the aneurysm, increasing the risk of rupture [8]. By combining machine learning with CFD simulations, a recent study [10] identified aneurysm location, mean surface curve and maximum flow velocity as important predictors for the risk of rupture of cerebral aneurysms. Focuses on how geometric features of vessels impact the risk of rupture from a datadriven approach and potentially serves as a complement to the haemodynamics models
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