Zeitschrift für Bluterkrankungen und Transfusionen

Abstrakt

Computer-Assisted Aneurysm Growth Evaluation and Detection (AGED): Comparison with Clinical Aneurysm Follow-Up

Aichi Chien*, Ziga Spiclin, Ziga Bizjak, Kambiz Nael

Background: Since growing Intracranial Aneurysms (IA) are more likely to rupture, detecting growth is an important part of unruptured IA follow-up. Recent studies have consistently shown that detecting IA growth can be challenging, especially in smaller aneurysms. In this study, we present an automated computational method to assist in aneurysm growth detection.

Methods: An analysis program, Aneurysm Growth Evaluation and Detection (AGED), based on IA images was developed. To verify the program can satisfactorily detect clinical aneurysm growth, we performed this comparative study using clinical determinations of growth during IA follow-up as a gold standard. Patients with unruptured, saccular IA followed by diagnostic brain CTA to monitor IA progression were reviewed. 48 IA image series from 20 longitudinally-followed ICA IA were analyzed using AGED and a set of IA morphologic features were calculated. Nonparametric statistical tests and ROC analysis were performed to evaluate the performance of each feature for growth detection.

Results: The set of automatically calculated morphologic features demonstrated comparable results to standard, manual clinical IA growth evaluation. Specifically, automatically calculated HMAX was superior (AUC=0.958) at distinguishing growing versus stable IA, followed by V, and SA (AUC=0.927 and 0.917, respectively).

Conclusion: Our findings support automatic methods of detecting IA growth from sequential imaging studies as a useful adjunct to standard clinical assessment. AGED-generated growth detection shows promise for characterization and detection of IA growth with potential to decrease variability associated with manual measurements.