A comparison of two methods to segment stent grafts in CT data

Late stent graft failure is a serious complication in endovascular repair of aortic aneurysms. Better understanding of the motion characteristics of stent grafts will be beneficial for designing future devices. In addition, analysis of stent graft movement in individual patients in vivo can be valuable for predicting stent graft failure in these patients. To be able to gather information on stent graft motion in a quick and robust fashion, an automatic segmentation method is required. In this work we compare two segmentation methods that produce a geometric model in the form of an undirected graph. The first method tracks along the centerline of the stent and segments the stent in 2D slices sampled orthogonal to it. The second method used a modified version of the minimum cost path (MCP) method to segment the stent directly in 3D. Using annotated reference data both methods were evaluated in an experiment. The results show that the centerline-based method and the MCP-based method have an accuracy of approximately 65% and 92%, respectively. The difference in accuracy can be explained by the fact that the centerline method makes assumptions about the topology of the stent which do not always hold in practice. This causes difficulties that are hard and sometimes impossible to overcome. In contrast, the MCP-based method works directly in 3D and is capable of segmenting a large variety of stent shapes and stent types.

[1]  Nikos Paragios,et al.  Learning deformation and structure simultaneously: In situ endograft deformation analysis , 2011, Medical Image Anal..

[2]  Horst Bunke Error-Tolerant Graph Matching: A Formal Framework and Algorithms , 1998, SSPR/SPR.

[3]  Francis K. H. Quek,et al.  Vessel extraction in medical images by wave-propagation and traceback , 2001, IEEE Transactions on Medical Imaging.

[4]  Karl D. Fritscher,et al.  Spatio-temporal changes and migration of stent grafts after endovascular aortic aneurysm repair , 2005 .

[5]  Fernando Mut,et al.  Image-based analysis of blood flow modification in stented aneurysms , 2009, Medical Imaging.

[6]  Cornelis H. Slump,et al.  A segmentation method for stentgrafts in the abdominal aorta from ECG-gated CTA data , 2008, SPIE Medical Imaging.

[7]  Cornelis H. Slump,et al.  Automatic segmentation of the wire frame of stent grafts from CT data , 2012, Medical Image Anal..

[8]  G. L. Moneta Endovascular versus Open Repair of Abdominal Aortic Aneurysm , 2010 .

[9]  Bernd Freisleben,et al.  Detection and visualization of endoleaks in CT data for monitoring of thoracic and abdominal aortic aneurysm stents , 2016, SPIE Medical Imaging.

[10]  Max A. Viergever,et al.  Multiscale vessel tracking , 2004, IEEE Transactions on Medical Imaging.

[11]  Michael Grass,et al.  Automatic generation of 3D coronary artery centerlines using rotational X-ray angiography , 2009, Medical Image Anal..

[12]  C Kleinstreuer,et al.  Computational analysis of type II endoleaks in a stented abdominal aortic aneurysm model. , 2006, Journal of biomechanics.

[13]  Nikos Paragios,et al.  Motion Analysis of Endovascular Stent-Grafts by MDL Based Registration , 2007, 2007 IEEE 11th International Conference on Computer Vision.

[14]  Cornelis H. Slump,et al.  Initial steps towards automatic segmentation of the wire frame of stent grafts in CT data , 2009, EMBC 2009.

[15]  Koen L. Vincken,et al.  Use of Dynamic Computed Tomography to Evaluate Pre- and Postoperative Aortic Changes in AAA Patients Undergoing Endovascular Aneurysm Repair , 2007, Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists.

[16]  Laurent D. Cohen,et al.  Fast extraction of minimal paths in 3D images and applications to virtual endoscopy , 2001, Medical Image Anal..

[17]  K L Vincken,et al.  Dynamic cine-CT angiography for the evaluation of the thoracic aorta; insight in dynamic changes with implications for thoracic endograft treatment. , 2006, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[18]  Nassir Navab,et al.  Quantification of abdominal aortic deformation after EVAR , 2009, Medical Imaging.

[19]  C Kleinstreuer,et al.  Analysis of biomechanical factors affecting stent-graft migration in an abdominal aortic aneurysm model. , 2006, Journal of biomechanics.

[20]  L. Cohen,et al.  Segmentation of 3D tubular objects with adaptive front propagation and minimal tree extraction for 3D medical imaging , 2007, Computer methods in biomechanics and biomedical engineering.

[21]  Jaap Buth,et al.  Long-Term Outcome of Open or Endovascular Repair of Abdominal Aortic Aneurysm , 2010 .

[22]  Diederick E Grobbee,et al.  Long-term outcome of open or endovascular repair of abdominal aortic aneurysm. , 2010, The New England journal of medicine.

[23]  Geoffrey D Rubin,et al.  Detection of endograft fractures with multidetector row computed tomography. , 2005, Journal of vascular surgery.

[24]  W A Kalender,et al.  System performance of multislice spiral computed tomography. , 2000, IEEE engineering in medicine and biology magazine : the quarterly magazine of the Engineering in Medicine & Biology Society.

[25]  F. Verzini,et al.  Durability of abdominal aortic endograft with the Talent Unidoc stent graft in common practice: Core lab reanalysis from the TAURIS multicenter study. , 2009, Journal of vascular surgery.

[26]  Rodney A. White,et al.  AneuRx stent graft versus open surgical repair of abdominal aortic aneurysms: multicenter prospective clinical trial. , 1999, Journal of vascular surgery.

[27]  Almar Klein,et al.  Detectability of motions in AAA with ECG-gated CTA: a quantitative study. , 2009, Medical physics.

[28]  Oscar Camara,et al.  Generalized Overlap Measures for Evaluation and Validation in Medical Image Analysis , 2006, IEEE Transactions on Medical Imaging.

[29]  Aly A. Farag,et al.  Robust segmentation of tubular structures in medical images , 2008, SPIE Medical Imaging.

[30]  Rüdiger Dillmann,et al.  Computational biomechanics and experimental validation of vessel deformation based on 4D-CT imaging of the porcine aorta , 2009, Medical Imaging.

[31]  Larry H Hollier,et al.  Mechanical failure of prosthetic human implants: a 10-year experience with aortic stent graft devices. , 2003, Journal of vascular surgery.

[32]  Julien Jomier,et al.  Spatial Graphs for Intra-cranial Vascular Network Characterization, Generation, and Discrimination , 2005, MICCAI.

[33]  Hüseyin Tek,et al.  Robust Vessel Tree Modeling , 2008, MICCAI.

[34]  C. Kleinstreuer,et al.  Fluid-structure interaction analyses of stented abdominal aortic aneurysms. , 2007, Annual review of biomedical engineering.

[35]  Armando Manduca,et al.  Automatic segmentation and co-registration of gated CT angiography datasets: measuring abdominal aortic pulsatility , 2007, SPIE Medical Imaging.

[36]  S. Stavropoulos,et al.  Imaging techniques for detection and management of endoleaks after endovascular aortic aneurysm repair. , 2007, Radiology.