Volume estimation of cerebral aneurysms from biplane DSA: a comparison with measurements on 3D rotational angiography data

A cerebral aneurysm is a persistent localized dilatation of the wall of a cerebral vessel. One of the techniques applied to treat cerebral aneurysms is the Guglielmi detachable coil (GDC) embolization. The goal of this technique is to embolize the aneurysm with a mesh of platinum coils to reduce the risk of aneurysm rupture. However, due to the blood pressure it is possible that the platinum wire is deformed. In this case, re-embolization of the aneurysm is necessary. The aim of this project is to develop a computer program to estimate the volume of cerebral aneurysms from archived laser hard copies of biplane digital subtraction angiography (DSA) images. Our goal is to determine the influence of the packing percentage, i.e., the ratio between the volume of the aneurysm and the volume of the coil mesh, on the stability of the coil mesh in time. The method we apply to estimate the volume of the cerebral aneurysms is based on the generation of a 3-D geometrical model of the aneurysm from two biplane DSA images. This 3-D model can be seen as an stack of 2-D ellipsis. The volume of the aneurysm is the result of performing a numerical integration of this stack. The program was validated using balloons filled with contrast agent. The availability of 3-D data for some of the aneurysms enabled to perform a comparison of the results of this method with techniques based on 3-D data.