Surface Curvature as a Classifier of Abdominal Aortic Aneurysms: A Comparative Analysis

An abdominal aortic aneurysm (AAA) carries one of the highest mortality rates among vascular diseases when it ruptures. To predict the role of surface curvature in rupture risk assessment, a discriminatory analysis of aneurysm geometry characterization was conducted. Data was obtained from 205 patient-specific computed tomography image sets corresponding to three AAA population subgroups: patients under surveillance, those that underwent elective repair of the aneurysm, and those with an emergent repair. Each AAA was reconstructed and their surface curvatures estimated using the biquintic Hermite finite element method. Local surface curvatures were processed into ten global curvature indices. Statistical analysis of the data revealed that the L2-norm of the Gaussian and Mean surface curvatures can be utilized as classifiers of the three AAA population subgroups. The application of statistical machine learning on the curvature features yielded 85.5% accuracy in classifying electively and emergent repaired AAAs, compared to a 68.9% accuracy obtained by using maximum aneurysm diameter alone. Such combination of non-invasive geometric quantification and statistical machine learning methods can be used in a clinical setting to assess the risk of rupture of aneurysms during regular patient follow-ups.

[1]  M J Fagan,et al.  A comparative study of aortic wall stress using finite element analysis for ruptured and non-ruptured abdominal aortic aneurysms. , 2004, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[2]  RM Greenhalgh,et al.  Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial , 2004, The Lancet.

[3]  Ender A Finol,et al.  Semiautomatic vessel wall detection and quantification of wall thickness in computed tomography images of human abdominal aortic aneurysms. , 2010, Medical physics.

[4]  R. Limet,et al.  Determination of the expansion rate and incidence of rupture of abdominal aortic aneurysms. , 1991, Journal of vascular surgery.

[5]  Steven W. Zucker,et al.  Inferring Surface Trace and Differential Structure from 3-D Images , 1990, IEEE Trans. Pattern Anal. Mach. Intell..

[6]  David J. Hawkes,et al.  Measures of folding applied to the development of the human fetal brain , 2002, IEEE Transactions on Medical Imaging.

[7]  Ian H. Witten,et al.  The WEKA data mining software: an update , 2009, SKDD.

[8]  Matthew J. Thompson,et al.  Epidemiological study of the relationship between volume and outcome after abdominal aortic aneurysm surgery in the UK from 2000 to 2005 , 2007, The British journal of surgery.

[9]  G. H. Templeton,et al.  In vivo 3-D reconstruction and geometric characterization of the right ventricular free wall , 1993, Annals of Biomedical Engineering.

[10]  Gary R Johnson,et al.  Immediate repair compared with surveillance of small abdominal aortic aneurysms. , 2002, The New England journal of medicine.

[11]  Suguna Pappu,et al.  Beyond fusiform and saccular: a novel quantitative tortuosity index may help classify aneurysm shape and predict aneurysm rupture potential. , 2008, Annals of vascular surgery.

[12]  C. R. Ethier,et al.  Requirements for mesh resolution in 3D computational hemodynamics. , 2001, Journal of biomechanical engineering.

[13]  L. A. Anderson Abdominal aortic aneurysm. , 2001, The Journal of cardiovascular nursing.

[14]  P. Hunter,et al.  Mathematical model of geometry and fibrous structure of the heart. , 1991, The American journal of physiology.

[15]  M. L. Raghavan,et al.  Three-Dimensional Geometrical Characterization of Cerebral Aneurysms , 2004, Annals of Biomedical Engineering.

[16]  RAP Scott,et al.  The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomised controlled trial , 2002, The Lancet.

[17]  David A. Vorp,et al.  In Vivo Three-Dimensional Surface Geometry of Abdominal Aortic Aneurysms , 1999, Annals of Biomedical Engineering.

[18]  G. Giannakoulas,et al.  Predicting the Risk of Rupture of Abdominal Aortic Aneurysms by Utilizing Various Geometrical Parameters: Revisiting the Diameter Criterion , 2006, Angiology.

[19]  Elena S. Di Martino,et al.  Three-dimensional geometrical characterization of abdominal aortic aneurysms: image-based wall thickness distribution. , 2009, Journal of biomechanical engineering.

[20]  Mark F Fillinger,et al.  Prediction of rupture risk in abdominal aortic aneurysm during observation: wall stress versus diameter. , 2003, Journal of vascular surgery.

[21]  Simon G. Thompson,et al.  Abdominal Aortic Aneurysm Expansion: Risk Factors and Time Intervals for Surveillance , 2004, Circulation.

[22]  Ender A. Finol,et al.  Quantitative Assessment of Abdominal Aortic Aneurysm Geometry , 2010, Annals of Biomedical Engineering.

[23]  W. Kultangwattana,et al.  Diagnosis of the Abdominal Aorta Aneurysm in Magnetic Resonance Imaging Images , 2009 .

[24]  M. L. Raghavan,et al.  Quantified aneurysm shape and rupture risk. , 2005, Journal of neurosurgery.

[25]  David A. Vorp,et al.  Surface Geometric Analysis of Anatomic Structures Using Biquintic Finite Element Interpolation , 2004, Annals of Biomedical Engineering.

[26]  A. R. Brady,et al.  Mortality results for randomised controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms , 1998, The Lancet.