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Geometric inaccuracy and co-registration errors for CT, DynaCT and MRI images used in robotic stereotactic radiosurgery treatment planning. Phys Med 2020; 69:212-222. [PMID: 31918373 DOI: 10.1016/j.ejmp.2019.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 11/08/2019] [Accepted: 12/04/2019] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To measure the combined errors due to geometric inaccuracy and image co-registration on secondary images (dynamic CT angiography (dCTA), 3D DynaCT angiography (DynaCTA), and magnetic resonance images (MRI)) that are routinely used to aid in target delineation and planning for stereotactic radiosurgery (SRS). METHODS Three phantoms (one commercial and two in-house built) and two different analysis approaches (commercial and MATLAB based) were used to quantify the magnitude of geometric image distortion and co-registration errors for different imaging modalities within CyberKnife's MultiPlan treatment planning software. For each phantom, the combined errors were reported as a mean target registration error (TRE). The mean TRE's for different intramodality imaging parameters (e.g., mAs, kVp, and phantom set-ups) and for dCTA, DynaCTA, and MRI systems were measured. RESULTS Only X-ray based imaging can be performed with the commercial phantom, and the mean TRE ± standard deviation values were large compared to the in-house analysis using MATLAB. With the 3D printed phantom, even drastic changes in treatment planning CT imaging protocols did not greatly influence the mean TRE (<0.5 mm for a 1 mm slice thickness CT). For all imaging modalities, the largest mean TRE was found on DynaCT, followed by T2-weighted MR images (albeit all <1 mm). CONCLUSIONS The user may overestimate the mean TRE if the commercial phantom and MultiPlan were used solely. The 3D printed phantom design is a sensitive and suitable quality assurance tool for measuring 3D geometric inaccuracy and co-registration errors across all imaging modalities.
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Yuki I, Ishibashi T, Dahmani C, Kato N, Ikemura A, Abe Y, Otani K, Kodama T, Kan I, Nishimura K, Murayama Y. Combination of high-resolution cone beam computed tomography and metal artefact reduction software: a new image fusion technique for evaluating intracranial stent apposition after aneurysm treatment. BMJ Case Rep 2019; 12:12/9/e230687. [PMID: 31533950 PMCID: PMC6754653 DOI: 10.1136/bcr-2019-230687] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We introduce a new imaging technique to improve visualisation of stent apposition after endovascular treatment of brain aneurysms employing high-resolution cone beam CT and three-dimensional digital subtraction angiography. After performing a stent-assisted coil embolisation of brain aneurysm, the image datasets were processed with a metal artefact reduction software followed by the automated image fusion programmes. Two patients who underwent aneurysm coiling using a Neuroform stent were evaluated. The reconstructed 3D images showed a detailed structure of the stent struts and identified malappositions of the deployed stents. Case 1 showed good apposition on the outer curvature side of the carotid siphon, while the inner curvature side showed prominent malapposition. Case 2, with multiple aneurysms, showed good apposition on both outer and inner curvature sides, although inward prolapse of the struts was observed. This new imaging technique may help evaluate stent apposition after the endovascular aneurysm treatment.
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Affiliation(s)
- Ichiro Yuki
- Department of Neurosurgery, University of California Irvine, Irvine, California, USA.,Department of Neurosurgery, The Jikei University Hospital, Tokyo, Japan
| | - Toshihiro Ishibashi
- Division of Endovascular neurosurgery, Department of Neurosurgery, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Naoki Kato
- Department of Neurosurgery, The Jikei University Hospital, Tokyo, Japan
| | - Ayako Ikemura
- Department of Neurosurgery, The Jikei University Hospital, Tokyo, Japan
| | - Yukiko Abe
- Department of Radiology, The Jikei University Hospital, Tokyo, Japan
| | - Katharina Otani
- AT Innovation Department, Siemens Healthcare K.K., Tokyo, Japan
| | - Tomonobu Kodama
- Department of Neurosurgery, The Jikei University Hospital, Tokyo, Japan
| | - Issei Kan
- Department of Neurosurgery, The Jikei University Hospital, Tokyo, Japan
| | - Kengo Nishimura
- Department of Neurosurgery, The Jikei University Hospital, Tokyo, Japan
| | - Yuichi Murayama
- Department of Neurosurgery, The Jikei University Hospital, Tokyo, Japan
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Kawauchi S, Chida K, Moritake T, Matsumaru Y, Hamada Y, Sakuma H, Yoda S, Sun L, Sato M, Tsuruta W. ESTIMATION OF PATIENT LENS DOSE ASSOCIATED WITH C-ARM CONE-BEAM COMPUTED TOMOGRAPHY USAGE DURING INTERVENTIONAL NEURORADIOLOGY. RADIATION PROTECTION DOSIMETRY 2019; 184:138-147. [PMID: 30452704 DOI: 10.1093/rpd/ncy188] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 09/05/2018] [Accepted: 10/13/2018] [Indexed: 06/09/2023]
Abstract
The purpose of this study was to investigate the dose distribution and lens doses associated with C-arm cone-beam computed tomography (CBCT), using a head phantom, and to estimate the contribution ratio of C-arm CBCT to each patient's lens dose during interventional neuroradiology ('lens dose ratio') in 109 clinical cases. In the phantom study, the peak skin doses and respective right and left lens doses of C-arm CBCT were as follows: 63.0 ± 1.9 mGy, 19.7 ± 1.4 mGy and 21.9 ± 0.8 mGy in whole brain C-arm CBCT and 39.2 ± 1.4 mGy, 4.7 ± 0.9 mGy and 3.6 ± 0.3 mGy in high-resolution C-arm CBCT. In the clinical study, the lens dose ratios were 25.4 ± 8.7% in the right lens and 19.1 ± 9.8% in the left lens. This study shows that, on average, ~25% of patients' total lens dose was contributed by C-arm CBCT.
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Affiliation(s)
- Satoru Kawauchi
- Department of Radiology, Toranomon Hospital, 2-2-2 Toranomon, Minato, Tokyo, Japan
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba, Sendai, Miyagi, Japan
| | - Koichi Chida
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba, Sendai, Miyagi, Japan
| | - Takashi Moritake
- Department of Radiological Health Science, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi, Kitakyushu, Fukuoka, Japan
| | - Yuji Matsumaru
- Division for Stroke Prevention and Treatment, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Yusuke Hamada
- Department of Radiology, Toranomon Hospital, 2-2-2 Toranomon, Minato, Tokyo, Japan
| | - Hideyuki Sakuma
- Department of Radiology, Toranomon Hospital, 2-2-2 Toranomon, Minato, Tokyo, Japan
| | - Shogo Yoda
- Department of Radiology, Toranomon Hospital, 2-2-2 Toranomon, Minato, Tokyo, Japan
| | - Lue Sun
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Masayuki Sato
- Division for Stroke Prevention and Treatment, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Wataro Tsuruta
- Department of Endovascular Neurosurgery, Toranomon Hospital, 2-2-2 Toranomon, Minato, Tokyo, Japan
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Hasegawa H, Hanakita S, Shin M, Kawashima M, Kin T, Takahashi W, Suzuki Y, Shinya Y, Ono H, Shojima M, Nakatomi H, Saito N. Integration of rotational angiography enables better dose planning in Gamma Knife radiosurgery for brain arteriovenous malformations. J Neurosurg 2018; 129:17-25. [DOI: 10.3171/2018.7.gks181565] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 07/16/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVEIn Gamma Knife radiosurgery (GKS) for arteriovenous malformations (AVMs), CT angiography (CTA), MRI, and digital subtraction angiography (DSA) are generally used to define the nidus. Although the AVM angioarchitecture can be visualized with superior resolution using rotational angiography (RA), the efficacy of integrating RA into the GKS treatment planning process has not been elucidated.METHODSUsing data collected from 25 consecutive patients with AVMs who were treated with GKS at the authors’ institution, two neurosurgeons independently created treatment plans for each patient before and after RA integration. For all patients, MR angiography, contrasted T1 imaging, CTA, DSA, and RA were performed before treatment. The prescription isodose volume before (PIVB) and after (PIVA) RA integration was measured. For reference purposes, a reference target volume (RTV) for each nidus was determined by two other physicians independent of the planning surgeons, and the RTV covered by the PIV (RTVPIV) was established. The undertreated volume ratio (UVR), overtreated volume ratio (OVR), and Paddick’s conformal index (CI), which were calculated as RTVPIV/RTV, RTVPIV/PIV, and (RTVPIV)2/(RTV × PIV), respectively, were measured by each neurosurgeon before and after RA integration, and the surgeons’ values at each point were averaged. Wilcoxon signed-rank tests were used to compare the values obtained before and after RA integration. The percentage change from before to after RA integration was calculated for the average UVR (%ΔUVRave), OVR (%ΔOVRave), and CI (%ΔCIave) in each patient, as ([value after RA integration]/[value before RA integration] − 1) × 100. The relationships between prior histories and these percentage change values were examined using Wilcoxon signed-rank tests.RESULTSThe average values obtained by the two surgeons for the median UVR, OVR, and CI were 0.854, 0.445, and 0.367 before RA integration and 0.882, 0.478, and 0.463 after RA integration, respectively. All variables significantly improved after compared with before RA integration (UVR, p = 0.009; OVR, p < 0.001; CI, p < 0.001). Prior hemorrhage was significantly associated with larger %ΔOVRave (median 20.8% vs 7.2%; p = 0.023) and %ΔCIave (median 33.9% vs 13.8%; p = 0.014), but not %ΔUVRave (median 4.7% vs 4.0%; p = 0.449).CONCLUSIONSIntegrating RA into GKS treatment planning may permit better dose planning owing to clearer visualization of the nidus and, as such, may reduce undertreatment and waste irradiation. Further studies examining whether the observed RA-related improvement in dose planning also improves the radiosurgical outcome are needed.
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Affiliation(s)
| | | | | | | | | | | | - Yuichi Suzuki
- 2Radiology, University of Tokyo Hospital, Tokyo, Japan
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Al-Smadi AS, Elmokadem A, Shaibani A, Hurley MC, Potts MB, Jahromi BS, Ansari SA. Adjunctive Efficacy of Intra-Arterial Conebeam CT Angiography Relative to DSA in the Diagnosis and Surgical Planning of Micro-Arteriovenous Malformations. AJNR Am J Neuroradiol 2018; 39:1689-1695. [PMID: 30093482 DOI: 10.3174/ajnr.a5745] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 06/12/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Micro-arteriovenous malformations are an underrecognized etiology of intracranial hemorrhage. Our study aimed to assess the adjunctive efficacy of intra-arterial conebeam CTA relative to DSA in the diagnosis and surgical planning of intracranial micro-AVMs. MATERIALS AND METHODS We performed a retrospective study of all micro-AVMs (≤1-cm nidus) at our institution. Blinded neuroradiologists qualitatively graded DSA and intra-arterial conebeam CTA images for the detection of specific micro-AVM anatomic parameters (arterial feeder, micronidus, and venous drainer) and defined an overall diagnostic value. Statistical and absolute differences in the overall diagnostic values defined the relative intra-arterial conebeam CTA diagnostic values, respectively. Blinded neurosurgeons reported their treatment approach after DSA and graded the adjunctive value of intra-arterial conebeam CTA to improve or modify treatment. Intra-arterial conebeam CTA efficacy was defined as interobserver agreement in the relative intra-arterial conebeam CTA diagnostic and/or treatment-planning value scores. RESULTS Ten patients with micro-AVMs presented with neurologic deficits and/or intracranial hemorrhages. Both neuroradiologists assigned a higher overall intra-arterial conebeam CTA diagnostic value (P < .05), secondary to improved evaluation of both arterial feeders and the micronidus, with good interobserver agreement (τ = 0.66, P = .018) in the relative intra-arterial conebeam CTA diagnostic value. Both neurosurgeons reported that integrating the intra-arterial conebeam CTA data into their treatment plan would allow more confident localization for surgical/radiation treatment (8/10; altering the treatment plan in 1 patient), with good interobserver agreement in the relative intra-arterial conebeam CTA treatment planning value (τ = 0.73, P = .025). CONCLUSIONS Adjunctive intra-arterial conebeam CTA techniques are more effective in the diagnostic identification and anatomic delineation of micro-AVMs, relative to DSA alone, with the potential to improve microsurgical or radiosurgery treatment planning.
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Affiliation(s)
- A S Al-Smadi
- From the Departments of Radiology (A.S.A.-S., A.E., A.S., M.C.H., M.B.P., B.S.J., S.A.A.)
| | - A Elmokadem
- From the Departments of Radiology (A.S.A.-S., A.E., A.S., M.C.H., M.B.P., B.S.J., S.A.A.)
| | - A Shaibani
- From the Departments of Radiology (A.S.A.-S., A.E., A.S., M.C.H., M.B.P., B.S.J., S.A.A.).,Neurological Surgery (A.S., M.C.H., M.B.P., B.S.J., S.A.A.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - M C Hurley
- From the Departments of Radiology (A.S.A.-S., A.E., A.S., M.C.H., M.B.P., B.S.J., S.A.A.).,Neurological Surgery (A.S., M.C.H., M.B.P., B.S.J., S.A.A.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - M B Potts
- From the Departments of Radiology (A.S.A.-S., A.E., A.S., M.C.H., M.B.P., B.S.J., S.A.A.).,Neurological Surgery (A.S., M.C.H., M.B.P., B.S.J., S.A.A.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - B S Jahromi
- From the Departments of Radiology (A.S.A.-S., A.E., A.S., M.C.H., M.B.P., B.S.J., S.A.A.).,Neurological Surgery (A.S., M.C.H., M.B.P., B.S.J., S.A.A.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - S A Ansari
- From the Departments of Radiology (A.S.A.-S., A.E., A.S., M.C.H., M.B.P., B.S.J., S.A.A.) .,Neurology (S.A.A.).,Neurological Surgery (A.S., M.C.H., M.B.P., B.S.J., S.A.A.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois
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Talbott JF, Cooke DL, Mabray MC, Larson PS, Amans MR, Hetts SW, Wilson MW, Moore T, Salegio EA. Accuracy of image-guided percutaneous injection into a phantom spinal cord utilizing flat panel detector CT with MR fusion and integrated navigational software. J Neurointerv Surg 2018; 10:e37. [PMID: 29666181 DOI: 10.1136/neurintsurg-2018-013878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 03/22/2018] [Accepted: 03/25/2018] [Indexed: 11/04/2022]
Abstract
PURPOSE To evaluate the accuracy of percutaneous fluoroscopic injection into the spinal cord of a spine phantom utilizing integrated navigational guidance from fused flat panel detector CT (FDCT) and MR datasets. Conventional and convection-enhanced delivery (CED) techniques were evaluated. MATERIALS AND METHODS FDCT and MR datasets of a swine thoracic spine phantom were co-registered using an integrated guidance system and surface to spinal cord target trajectory planning was performed on the fused images. Under real-time fluoroscopic guidance with pre-planned trajectory overlay, spinal cord targets were accessed via a coaxial technique. Final needle tip position was compared with a pre-determined target on 10 independent passes. In a subset of cases, contrast was injected into the central spinal cord with a 25G spinal needle or customized 200 µm inner diameter step design cannula for CED. RESULTS Average needle tip deviation from target measured 0.92±0.5 mm in the transverse, 0.47±0.4 mm in the anterior-posterior, and 1.67±1.2 mm in the craniocaudal dimension for an absolute distance error of 2.12±1.12 mm. CED resulted in elliptical intramedullary diffusion of contrast compared with primary reflux observed with standard needle injection. CONCLUSIONS These phantom feasibility data demonstrate a minimally invasive percutaneous approach for targeted injection into the spinal cord utilizing real-time fluoroscopy aided by overlay trajectories derived from fused MRI and FDCT data sets with a target error of 2.1 mm. Intramedullary diffusion of injectate in the spinal cord is facilitated with CED compared with standard injection technique. Pre-clinical studies in large animal models are warranted.
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Affiliation(s)
- Jason F Talbott
- Department of Radiology and Biomedical Imaging, University of California San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, California, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Daniel L Cooke
- Department of Radiology and Biomedical Imaging, University of California San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Marc C Mabray
- Department of Radiology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Paul S Larson
- Department of Neurological Surgery, University of California San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Matthew R Amans
- Department of Radiology and Biomedical Imaging, University of California San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Steven W Hetts
- Department of Radiology and Biomedical Imaging, University of California San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Mark W Wilson
- Department of Radiology and Biomedical Imaging, University of California San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Terilyn Moore
- Department of Radiology and Biomedical Imaging, University of California San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Ernesto A Salegio
- Department of Neurological Surgery, University of California San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, California, USA
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Iannaccone F, De Beule M, De Bock S, Van der Bom IMJ, Gounis MJ, Wakhloo AK, Boone M, Verhegghe B, Segers P. A Finite Element Method to Predict Adverse Events in Intracranial Stenting Using Microstents: In Vitro Verification and Patient Specific Case Study. Ann Biomed Eng 2015; 44:442-52. [DOI: 10.1007/s10439-015-1505-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 11/05/2015] [Indexed: 11/28/2022]
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van der Marel K, Gounis MJ, Weaver JP, de Korte AM, King RM, Arends JM, Brooks OW, Wakhloo AK, Puri AS. Grading of Regional Apposition after Flow-Diverter Treatment (GRAFT): a comparative evaluation of VasoCT and intravascular OCT. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011843] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BackgroundPoor vessel wall apposition of flow diverter (FD) stents poses risks for stroke-related complications when treating intracranial aneurysms, necessitating long-term surveillance imaging. To facilitate quantitative evaluation of deployed devices, a novel algorithm is presented that generates intuitive two-dimensional representations of wall apposition from either high-resolution contrast-enhanced cone-beam CT (VasoCT) or intravascular optical coherence tomography (OCT) images.MethodsVasoCT and OCT images were obtained after FD implant (n=8 aneurysms) in an experimental sidewall aneurysm model in canines. Surface models of the vessel wall and FD device were extracted, and the distance between them was presented on a two-dimensional flattened map. Maps and cross-sections at potential locations of malapposition detected on VasoCT-based maps were compared. The performance of OCT-based apposition detection was evaluated on manually labeled cross-sections using logistic regression against a thresholded (≥0.25 mm) apposition measure.ResultsVasoCT and OCT acquisitions yielded similar Grading of Regional Apposition after Flow-Diverter Treatment (GRAFT) apposition maps. GRAFT maps from VasoCT highlighted 16 potential locations of malapposition, of which two were found to represent malapposed device struts. Logistic regression showed that OCT could detect malapposition with a sensitivity of 98% and a specificity of 81%.ConclusionsGRAFT delivered quantitative and visually convenient representations of potential FD malapposition and occasional acute thrombus formation. A powerful combination for future neuroendovascular applications is foreseen with the superior resolution delivered by intravascular OCT.
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Flood TF, van der Bom IMJ, Strittmatter L, Puri AS, Hendricks GM, Wakhloo AK, Gounis MJ. Quantitative analysis of high-resolution, contrast-enhanced, cone-beam CT for the detection of intracranial in-stent hyperplasia. J Neurointerv Surg 2014; 7:118-25. [PMID: 24480728 PMCID: PMC4316917 DOI: 10.1136/neurintsurg-2013-010950] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Intracranial in-stent hyperplasia is a stroke-associated complication that requires routine surveillance. OBJECTIVE To compare the results of in vivo experiments to determine the accuracy and precision of in-stent hyperplasia measurements obtained with modified C-arm contrast-enhanced, cone-beam CT (CE-CBCT) imaging with those obtained by 'gold standard' histomorphometry. Additionally, to carry out clinical analyses comparing this CE-CBCT protocol with digital subtraction angiography (DSA). METHODS A non-binned CE-CBCT protocol (VasoCT) was used that acquires x-ray images with a small field-of-view and applies a full-scale reconstruction algorithm providing high-resolution three-dimensional (3D) imaging with 100 µm isotropic voxels. In an vivo porcine model, VasoCT cross-sectional area measurements were compared with gold standard vessel histology. VasoCT and DSA were used to calculate in-stent stenosis in 23 imaging studies. RESULTS Porcine VasoCT cross-sectional stent, lumen, and in-stent hyperplasia areas strongly correlated with histological measurements (r(2)=0.97, 0.93, 0.90; slope=1.14, 1.07, and 0.76, respectively; p<0.0001). Clinical VasoCT percentage stenosis correlated well with DSA percentage stenosis (r(2)=0.84; slope=0.76), and the two techniques were free of consistent bias (Bland-Altman, bias=3.29%; 95% CI -14.75% to 21.33%). An illustrative clinical case demonstrated the advantages of VasoCT, including 3D capability and non-invasive IV contrast administration, for detection of in-stent hyperplasia. CONCLUSIONS C-arm VasoCT is a high-resolution 3D capable imaging technique that has been validated in an animal model for measurement of in-stent tissue growth. Successful clinical implementation of the protocol was performed in a small case series.
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Affiliation(s)
- Thomas F Flood
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Imramsjah M J van der Bom
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Lara Strittmatter
- Department of Cell Biology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Ajit S Puri
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Gregory M Hendricks
- Department of Cell Biology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Ajay K Wakhloo
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Matthew J Gounis
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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