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Oliveira-Pinto J, Ferreira RS, Oliveira NFG, Hoeks S, Van Rijn MJ, Raa ST, Mansilha A, Verhagen HJM, Gonçalves FB. Total Luminal Volume Predicts Risk after Endovascular Aneurysm Repair. Eur J Vasc Endovasc Surg 2020; 59:918-927. [PMID: 32197997 DOI: 10.1016/j.ejvs.2020.02.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 01/09/2020] [Accepted: 02/17/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Large aneurysm diameter represents a well known predictor of late complications after endovascular aneurysm repair (EVAR). However, the role of the thrombus free lumen inside the abdominal aortic aneurysm (AAA) sac is not clear. It was hypothesised that greater luminal volume represents a relevant risk factor for late complications after EVAR. METHODS A retrospective cohort analysis was performed including all patients undergoing EVAR from 2005 to 2016 at a tertiary referral institution. Pre-operative AAA lumen volume was measured in centre lumen line reconstructions and patients were stratified into quartiles according to luminal volume. The primary endpoint was freedom from AAA related complications. Secondary endpoints were freedom from neck events (type 1A endoleak, migration >5 mm or any pre-emptive neck related intervention), iliac related events (type 1B endoleak or pre-emptive iliac related intervention), and overall survival. RESULTS Four hundred and four patients were included: 101 in the first quartile (Q1; <61 cm3). Patients with higher luminal volumes had wider, shorter, and more angulated proximal necks. There were more ruptured AAAs, more aorto-uni-iliac implanted devices and patients outside neck instructions for use in the 4th quartile. Five year freedom from AAA related complications was 79%, 66%, 58% and 56%, respectively (p = .007). At five years, freedom from neck related events was 86%, 84%, 73%, and 71%, respectively, for the four groups (p = .009), and freedom from iliac related events was 96%, 91%, 88%, and 88%, respectively (p = .335). On multivariable analysis, luminal volume was an independent predictor of late complications (Q4 vs. Q1 - hazard ratio: 1.91, 95% confidence interval 1.01-3.6, p = .046). Overall survival at five years was not affected by lumen volume (p = .75). CONCLUSION AAA luminal volume represents an important risk factor for AAA related complications. This information may be considered when deciding tailoring surveillance protocols after EVAR. However, larger studies are needed to validate this hypothesis.
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Affiliation(s)
- José Oliveira-Pinto
- Department of Vascular Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands; Department of Angiology and Vascular Surgery, Centro Hospitalar São João, Porto, Portugal; Department of Surgery and Physiology, Faculdade de Medicina da Univesidade do Porto, Porto, Portugal.
| | - Rita S Ferreira
- Department of Vascular Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands; Department of Angiology and Vascular Surgery, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisbon, Portugal; NOVA Medical School, Lisbon, Portugal
| | - Nelson F G Oliveira
- Department of Vascular Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands; Department of Angiology and Vascular Surgery, Hospital do Divino Espírito Santo, Ponta Delgada, Azores, Portugal
| | - Sanne Hoeks
- Department of Anaesthetics, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Marie J Van Rijn
- Department of Vascular Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Sander T Raa
- Department of Vascular Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Armando Mansilha
- Department of Angiology and Vascular Surgery, Centro Hospitalar São João, Porto, Portugal; Department of Surgery and Physiology, Faculdade de Medicina da Univesidade do Porto, Porto, Portugal
| | - Hence J M Verhagen
- Department of Vascular Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Frederico B Gonçalves
- Department of Vascular Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands; Department of Angiology and Vascular Surgery, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisbon, Portugal; NOVA Medical School, Lisbon, Portugal
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Bertrand-Grenier A, Zehtabi F, Lerouge S, Alturkistani H, Kauffmann C, Bodson-Clermont P, Salazkin I, Héon H, Cloutier G, Soulez G. Shear wave elasticity imaging for residual endoleak and thrombus characterisation after endoleak embolisation following endovascular aneurysm repair: a canine animal study. Eur Radiol Exp 2018; 2:28. [PMID: 30302580 PMCID: PMC6177487 DOI: 10.1186/s41747-018-0059-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 07/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate residual endoleak and thrombus organisation with shear wave imaging (SWI) after endoleak embolisation through an animal study. METHODS This prospective experimental study involved eight dogs with creation of 16 iliac aneurysms and type I endoleak after endovascular aneurysm repair (EVAR). Embolisation agents were injected into the sac to seal endoleak. SWI and colour flow Doppler ultrasound (DUS) were performed at implantation, one week, and one and three months after implantation; for three dogs, SWI and DUS were also performed six months after implantation. Digital subtraction angiography and contrast-enhanced computed tomography were performed at sacrifice. Macroscopic and histopathological analyses were processed to identify regions of interest (ROIs) for endoleak, fresh thrombus, organised thrombus and embolisation agent, where SWI elasticity moduli were compared. RESULTS At sacrifice, nine aneurysms had residual endoleak, while seven were sealed. Ten had a fresh and 15 had an organised thrombus. SWI was able to detect all endoleaks, including two cases undetected with DUS. Elasticity moduli of 0.2 kPa ± 0.1 kPa (mean ± SD), 9.5 kPa ± 3.3 kPa, 48.1 kPa ± 21.3 kPa and 44.9 kPa ± 23.7 kPa were found in the ROIs positioned in endoleaks, fresh thrombi, organised thrombi and embolisation agent, respectively. Elasticity values of endoleak and fresh thrombus were lower than those of organised thrombi and embolisation agent (p < 0.001). Stiffness of fresh thrombus at one week (8.7 kPa ± 3.6 kPa) increased at three months (30.2 kPa ± 13.8 kPa), indicating thrombus maturation (p < 0.001). CONCLUSIONS In a dog model of iliac EVAR, SWI was able to identify endoleak, thrombus maturation and embolising agents after endoleak embolisation.
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Affiliation(s)
- Antony Bertrand-Grenier
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), 900 rue St Denis, Montréal, Québec, H2X 0A9, Canada.,Laboratoire de biorhéologie et d'ultrasonographie médicale, CRCHUM, Montréal, Québec, Canada.,Laboratoire clinique de traitement d'images, CRCHUM, Montréal, Québec, Canada.,Département de physique, Université de Montréal, Montréal, Québec, Canada
| | - Fatemeh Zehtabi
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), 900 rue St Denis, Montréal, Québec, H2X 0A9, Canada.,Département de génie mécanique, École de technologie supérieure, Montréal, Québec, Canada
| | - Sophie Lerouge
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), 900 rue St Denis, Montréal, Québec, H2X 0A9, Canada.,Département de génie mécanique, École de technologie supérieure, Montréal, Québec, Canada.,Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, Québec, Canada.,Institut de génie biomédical, Université de Montréal, Montréal, Québec, Canada
| | - Husain Alturkistani
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), 900 rue St Denis, Montréal, Québec, H2X 0A9, Canada.,Laboratoire clinique de traitement d'images, CRCHUM, Montréal, Québec, Canada.,Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, Québec, Canada.,Département de radiologie, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
| | - Claude Kauffmann
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), 900 rue St Denis, Montréal, Québec, H2X 0A9, Canada.,Laboratoire clinique de traitement d'images, CRCHUM, Montréal, Québec, Canada
| | - Paule Bodson-Clermont
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), 900 rue St Denis, Montréal, Québec, H2X 0A9, Canada
| | - Igor Salazkin
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), 900 rue St Denis, Montréal, Québec, H2X 0A9, Canada
| | - Hélène Héon
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), 900 rue St Denis, Montréal, Québec, H2X 0A9, Canada
| | - Guy Cloutier
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), 900 rue St Denis, Montréal, Québec, H2X 0A9, Canada.,Laboratoire de biorhéologie et d'ultrasonographie médicale, CRCHUM, Montréal, Québec, Canada.,Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, Québec, Canada.,Institut de génie biomédical, Université de Montréal, Montréal, Québec, Canada
| | - Gilles Soulez
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), 900 rue St Denis, Montréal, Québec, H2X 0A9, Canada. .,Laboratoire clinique de traitement d'images, CRCHUM, Montréal, Québec, Canada. .,Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, Québec, Canada. .,Département de radiologie, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada. .,Institut de génie biomédical, Université de Montréal, Montréal, Québec, Canada.
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Bertrand-Grenier A, Lerouge S, Tang A, Salloum E, Therasse E, Kauffmann C, Héon H, Salazkin I, Cloutier G, Soulez G. Abdominal aortic aneurysm follow-up by shear wave elasticity imaging after endovascular repair in a canine model. Eur Radiol 2016; 27:2161-2169. [PMID: 27572808 DOI: 10.1007/s00330-016-4524-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 07/20/2016] [Accepted: 07/21/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To investigate if shear wave imaging (SWI) can detect endoleaks and characterize thrombus organization in abdominal aortic aneurysms (AAAs) after endovascular aneurysm repair. METHODS Stent grafts (SGs) were implanted in 18 dogs after surgical creation of type I endoleaks (four AAAs), type II endoleaks (13 AAAs) and no endoleaks (one AAA). Color flow Doppler ultrasonography (DUS) and SWI were performed before SG implantation (baseline), on days 7, 30 and 90 after SG implantation, and on the day of the sacrifice (day 180). Angiography, CT scans and macroscopic tissue sections obtained on day 180 were evaluated for the presence, size and type of endoleaks, and thrombi were characterized as fresh or organized. Endoleak areas in aneurysm sacs were identified on SWI by two readers and compared with their appearance on DUS, CT scans and macroscopic examination. Elasticity moduli were calculated in different regions (endoleaks, and fresh and organized thrombi). RESULTS All 17 endoleaks (100 %) were identified by reader 1, whereas 16 of 17 (94 %) were detected by reader 2. Elasticity moduli in endoleaks, and in areas of organized thrombi and fresh thrombi were 0.2 ± 0.4, 90.0 ± 48.2 and 13.6 ± 4.5 kPa, respectively (P < 0.001 between groups). SWI detected endoleaks while DUS (three endoleaks) and CT (one endoleak) did not. CONCLUSIONS SWI has the potential to detect endoleaks and evaluate thrombus organization based on the measurement of elasticity. KEY POINTS • SWI has the potential to detect endoleaks in post-EVAR follow-up. • SWI has the potential to characterize thrombus organization in post-EVAR follow-up. • SWI may be combined with DUS in post-EVAR surveillance of endoleak.
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Affiliation(s)
- Antony Bertrand-Grenier
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.,Laboratoire de biorhéologie et d'ultrasonographie médicale, CRCHUM, Montréal, Québec, Canada.,Laboratoire clinique de traitement d'images, CRCHUM, Montréal, Québec, Canada.,Département de physique, Université de Montréal, Montréal, Québec, Canada
| | - Sophie Lerouge
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.,Laboratoire de biomatériaux endovasculaire, CRCHUM, Montréal, Québec, Canada.,Département de génie mécanique, École de technologie supérieure, Montréal, Québec, Canada
| | - An Tang
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.,Laboratoire clinique de traitement d'images, CRCHUM, Montréal, Québec, Canada.,Département de radiologie, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.,Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, Québec, Canada.,Institut de génie biomédical, Université de Montréal, Montréal, Québec, Canada
| | - Eli Salloum
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.,Laboratoire de biorhéologie et d'ultrasonographie médicale, CRCHUM, Montréal, Québec, Canada.,Laboratoire clinique de traitement d'images, CRCHUM, Montréal, Québec, Canada
| | - Eric Therasse
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.,Département de radiologie, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.,Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, Québec, Canada
| | - Claude Kauffmann
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.,Laboratoire clinique de traitement d'images, CRCHUM, Montréal, Québec, Canada.,Département de radiologie, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.,Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, Québec, Canada
| | - Hélène Héon
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada
| | - Igor Salazkin
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada
| | - Guy Cloutier
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.,Laboratoire de biorhéologie et d'ultrasonographie médicale, CRCHUM, Montréal, Québec, Canada.,Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, Québec, Canada.,Institut de génie biomédical, Université de Montréal, Montréal, Québec, Canada
| | - Gilles Soulez
- Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada. .,Laboratoire clinique de traitement d'images, CRCHUM, Montréal, Québec, Canada. .,Département de radiologie, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada. .,Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, Québec, Canada. .,Institut de génie biomédical, Université de Montréal, Montréal, Québec, Canada.
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Salloum E, Bertrand-Grenier A, Lerouge S, Kauffman C, Héon H, Therasse E, Salazkin I, Roy Cardinal MH, Cloutier G, Soulez G. Endovascular Repair of Abdominal Aortic Aneurysm: Follow-up with Noninvasive Vascular Elastography in a Canine Model. Radiology 2015; 279:410-9. [PMID: 26690905 DOI: 10.1148/radiol.2015142098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To assess the ability of noninvasive vascular elastography (NIVE) to help characterize endoleaks and thrombus organization in a canine model of abdominal aortic aneurysm after endovascular aneurysm repair with stent-grafts, in comparison with computed tomography (CT) and pathologic examination findings. MATERIALS AND METHODS All protocols were approved by the Animal Care Committee in accordance with the guidelines of the Canadian Council of Animal Care. Stent-grafts were implanted in a group of 18 dogs with aneurysms created in the abdominal aorta. Type I endoleak was created in four aneurysms; type II endoleak, in 13 aneurysms; and no endoleak, in one aneurysm. Doppler ultrasonography and NIVE examinations were performed at baseline and at 1-week, 1-month, 3-month, and 6-month follow-up. Angiography, CT, and macroscopic tissue examination were performed at sacrifice. Strain values were computed by using the Lagrangian speckle model estimator. Areas of endoleak, solid organized thrombus, and fresh thrombus were identified and segmented by comparing the results of CT and macroscopic tissue examination. Strain values were compared by using the Wilcoxon rank-sum and Kruskal-Wallis tests. RESULTS All stent-grafts were successfully deployed, and endoleaks were clearly depicted in the last follow-up elastography examinations. Maximal axial strains over consecutive heart cycles in endoleak, organized thrombus, and fresh thrombus areas were 0.78% ± 0.22, 0.23% ± 0.02, 0.10% ± 0.04, respectively. Strain values were significantly different between endoleak and organized or fresh thrombus areas (P < .000) and between organized and fresh thrombus areas (P < .0002). No correlation was found between strain values and type of endoleak, sac pressure, endoleak size, and aneurysm size. CONCLUSION NIVE may be able to help characterize endoleak and thrombus organization, regardless of the size, pressure, and type of endoleak.
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Affiliation(s)
- Eli Salloum
- From the Department of Radiology, Radio-Oncology and Nuclear Medicine, and Institute of Biomedical Engineering, Université de Montréal, Montreal, Quebec, Canada (E.S., A.B., C.K., E.T., G.C., G.S.); Department of Radiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (E.T., G.S.); Centre de Recherche de l'Université de Montréal, 900 rue Saint-Denis, Montreal, QC, Canada H2X 0A9 (E.S., A.B., S.L., C.K., H.H., E.T., I.S., M.H.R.C., G.C., G.S.); Laboratory of Biorheology and Medical Ultrasonics (E.S., A.B., M.H.R.C., G.C.) and Clinical Image Processing Laboratory (E.S., A.B., C.K., G.S.), Centre de Recherche de l'Université de Montréal, Montreal, Quebec, Canada; and Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada (S.L.)
| | - Antony Bertrand-Grenier
- From the Department of Radiology, Radio-Oncology and Nuclear Medicine, and Institute of Biomedical Engineering, Université de Montréal, Montreal, Quebec, Canada (E.S., A.B., C.K., E.T., G.C., G.S.); Department of Radiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (E.T., G.S.); Centre de Recherche de l'Université de Montréal, 900 rue Saint-Denis, Montreal, QC, Canada H2X 0A9 (E.S., A.B., S.L., C.K., H.H., E.T., I.S., M.H.R.C., G.C., G.S.); Laboratory of Biorheology and Medical Ultrasonics (E.S., A.B., M.H.R.C., G.C.) and Clinical Image Processing Laboratory (E.S., A.B., C.K., G.S.), Centre de Recherche de l'Université de Montréal, Montreal, Quebec, Canada; and Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada (S.L.)
| | - Sophie Lerouge
- From the Department of Radiology, Radio-Oncology and Nuclear Medicine, and Institute of Biomedical Engineering, Université de Montréal, Montreal, Quebec, Canada (E.S., A.B., C.K., E.T., G.C., G.S.); Department of Radiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (E.T., G.S.); Centre de Recherche de l'Université de Montréal, 900 rue Saint-Denis, Montreal, QC, Canada H2X 0A9 (E.S., A.B., S.L., C.K., H.H., E.T., I.S., M.H.R.C., G.C., G.S.); Laboratory of Biorheology and Medical Ultrasonics (E.S., A.B., M.H.R.C., G.C.) and Clinical Image Processing Laboratory (E.S., A.B., C.K., G.S.), Centre de Recherche de l'Université de Montréal, Montreal, Quebec, Canada; and Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada (S.L.)
| | - Claude Kauffman
- From the Department of Radiology, Radio-Oncology and Nuclear Medicine, and Institute of Biomedical Engineering, Université de Montréal, Montreal, Quebec, Canada (E.S., A.B., C.K., E.T., G.C., G.S.); Department of Radiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (E.T., G.S.); Centre de Recherche de l'Université de Montréal, 900 rue Saint-Denis, Montreal, QC, Canada H2X 0A9 (E.S., A.B., S.L., C.K., H.H., E.T., I.S., M.H.R.C., G.C., G.S.); Laboratory of Biorheology and Medical Ultrasonics (E.S., A.B., M.H.R.C., G.C.) and Clinical Image Processing Laboratory (E.S., A.B., C.K., G.S.), Centre de Recherche de l'Université de Montréal, Montreal, Quebec, Canada; and Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada (S.L.)
| | - Hélène Héon
- From the Department of Radiology, Radio-Oncology and Nuclear Medicine, and Institute of Biomedical Engineering, Université de Montréal, Montreal, Quebec, Canada (E.S., A.B., C.K., E.T., G.C., G.S.); Department of Radiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (E.T., G.S.); Centre de Recherche de l'Université de Montréal, 900 rue Saint-Denis, Montreal, QC, Canada H2X 0A9 (E.S., A.B., S.L., C.K., H.H., E.T., I.S., M.H.R.C., G.C., G.S.); Laboratory of Biorheology and Medical Ultrasonics (E.S., A.B., M.H.R.C., G.C.) and Clinical Image Processing Laboratory (E.S., A.B., C.K., G.S.), Centre de Recherche de l'Université de Montréal, Montreal, Quebec, Canada; and Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada (S.L.)
| | - Eric Therasse
- From the Department of Radiology, Radio-Oncology and Nuclear Medicine, and Institute of Biomedical Engineering, Université de Montréal, Montreal, Quebec, Canada (E.S., A.B., C.K., E.T., G.C., G.S.); Department of Radiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (E.T., G.S.); Centre de Recherche de l'Université de Montréal, 900 rue Saint-Denis, Montreal, QC, Canada H2X 0A9 (E.S., A.B., S.L., C.K., H.H., E.T., I.S., M.H.R.C., G.C., G.S.); Laboratory of Biorheology and Medical Ultrasonics (E.S., A.B., M.H.R.C., G.C.) and Clinical Image Processing Laboratory (E.S., A.B., C.K., G.S.), Centre de Recherche de l'Université de Montréal, Montreal, Quebec, Canada; and Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada (S.L.)
| | - Igor Salazkin
- From the Department of Radiology, Radio-Oncology and Nuclear Medicine, and Institute of Biomedical Engineering, Université de Montréal, Montreal, Quebec, Canada (E.S., A.B., C.K., E.T., G.C., G.S.); Department of Radiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (E.T., G.S.); Centre de Recherche de l'Université de Montréal, 900 rue Saint-Denis, Montreal, QC, Canada H2X 0A9 (E.S., A.B., S.L., C.K., H.H., E.T., I.S., M.H.R.C., G.C., G.S.); Laboratory of Biorheology and Medical Ultrasonics (E.S., A.B., M.H.R.C., G.C.) and Clinical Image Processing Laboratory (E.S., A.B., C.K., G.S.), Centre de Recherche de l'Université de Montréal, Montreal, Quebec, Canada; and Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada (S.L.)
| | - Marie-Hélène Roy Cardinal
- From the Department of Radiology, Radio-Oncology and Nuclear Medicine, and Institute of Biomedical Engineering, Université de Montréal, Montreal, Quebec, Canada (E.S., A.B., C.K., E.T., G.C., G.S.); Department of Radiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (E.T., G.S.); Centre de Recherche de l'Université de Montréal, 900 rue Saint-Denis, Montreal, QC, Canada H2X 0A9 (E.S., A.B., S.L., C.K., H.H., E.T., I.S., M.H.R.C., G.C., G.S.); Laboratory of Biorheology and Medical Ultrasonics (E.S., A.B., M.H.R.C., G.C.) and Clinical Image Processing Laboratory (E.S., A.B., C.K., G.S.), Centre de Recherche de l'Université de Montréal, Montreal, Quebec, Canada; and Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada (S.L.)
| | - Guy Cloutier
- From the Department of Radiology, Radio-Oncology and Nuclear Medicine, and Institute of Biomedical Engineering, Université de Montréal, Montreal, Quebec, Canada (E.S., A.B., C.K., E.T., G.C., G.S.); Department of Radiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (E.T., G.S.); Centre de Recherche de l'Université de Montréal, 900 rue Saint-Denis, Montreal, QC, Canada H2X 0A9 (E.S., A.B., S.L., C.K., H.H., E.T., I.S., M.H.R.C., G.C., G.S.); Laboratory of Biorheology and Medical Ultrasonics (E.S., A.B., M.H.R.C., G.C.) and Clinical Image Processing Laboratory (E.S., A.B., C.K., G.S.), Centre de Recherche de l'Université de Montréal, Montreal, Quebec, Canada; and Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada (S.L.)
| | - Gilles Soulez
- From the Department of Radiology, Radio-Oncology and Nuclear Medicine, and Institute of Biomedical Engineering, Université de Montréal, Montreal, Quebec, Canada (E.S., A.B., C.K., E.T., G.C., G.S.); Department of Radiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (E.T., G.S.); Centre de Recherche de l'Université de Montréal, 900 rue Saint-Denis, Montreal, QC, Canada H2X 0A9 (E.S., A.B., S.L., C.K., H.H., E.T., I.S., M.H.R.C., G.C., G.S.); Laboratory of Biorheology and Medical Ultrasonics (E.S., A.B., M.H.R.C., G.C.) and Clinical Image Processing Laboratory (E.S., A.B., C.K., G.S.), Centre de Recherche de l'Université de Montréal, Montreal, Quebec, Canada; and Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada (S.L.)
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