Abstract
An important step to reach a favorable outcome of abdominal endovascular aneurysm repair (EVAR) is preoperative sizing of the stent graft using computed tomography angiography (CTA) images of the abdominal aorta. A variety of costly image processing software options is available to obtain the necessary aortic measurements. A package that can be used for EVAR sizing is OsiriX Lite®-an open source, freely downloadable image processing option. This study assesses the concurrent validity of OsiriX Lite® when compared with commercially available 3Mensio Vascular® and Siemens Syngo.via®. CTA scans of 20 patients that underwent EVAR for abdominal aneurysm were selected, 10 elective and 10 ruptured. For each scan, 6 observers determined 20 parameters needed for proper stent graft sizing, 2 using Osirix Lite®, 3 using 3Mensio Vascular®, and 1 using Siemens Syngo.via®. For each parameter, an intraclass correlation coefficient (ICC) and a P-value were calculated. Interrater agreement was interpreted using the Koo and Li Guidelines. Time needed to perform EVAR planning was compared. Overall interrater agreement between the 3 sizing options was found to be either "good" or "moderate" for 16 out of 20 parameters (80%). Time needed to perform EVAR planning was not significantly different for Osirix Lite® (568sec) when compared with 3Mensio Vascular® (603sec) or Siemens Syngo.via® (659sec) with a P-value of 0.88. The authors conclude that Osirix Lite® is an accurate and time-effective image processing option for preoperative sizing of an EVAR stent graft when matched to 3Mensio Vascular® and Siemens Syngo.via®.
Highlights
An important step to reach a favorable outcome of abdominal endovascular aneurysm repair (EVAR) is preoperative sizing of the stent graft using computed tomography angiography (CTA) images of the abdominal aorta
Ever since Parodi et al reported on the transfemoral implantation of an intraluminal graft in 1991,2 endovascular aneurysm repair (EVAR) has evolved to become the main surgical intervention for abdominal aneurysm (AAA), resulting in a shorter hospital stay and less perioperative blood loss when compared with traditional open repair.[3]
Computed tomography combined with angiography (CTA) is the first-choice modality for EVAR planning, both before elective repair and in case of ruptured abdominal aneurysms.7e10
Summary
An important step to reach a favorable outcome of abdominal endovascular aneurysm repair (EVAR) is preoperative sizing of the stent graft using computed tomography angiography (CTA) images of the abdominal aorta. This study assesses the concurrent validity of OsiriX LiteÒ when compared with commercially available 3Mensio VascularÒ and Siemens Syngo.viaÒ. 6 observers determined 20 parameters needed for proper stent graft sizing, 2 using Osirix LiteÒ, 3 using 3Mensio VascularÒ, and 1 using Siemens Syngo.viaÒ. Time needed to perform EVAR planning was not significantly different for Osirix LiteÒ (568 sec) when compared with 3Mensio VascularÒ (603 sec) or Siemens Syngo.viaÒ (659 sec) with a P-value of 0.88. Conclusions: The authors conclude that Osirix LiteÒ is an accurate and time-effective image processing option for preoperative sizing of an EVAR stent graft when matched to 3Mensio VascularÒ and Siemens Syngo.viaÒ. Computed tomography combined with angiography (CTA) is the first-choice modality for EVAR planning, both before elective repair and in case of ruptured abdominal aneurysms.7e10
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