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Generic thrombus segmentation from pre- and post-operative CTA

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Abdominal aortic aneurysm (AAA) is a localized, permanent and irreversible enlargement of the artery, with the formation of thrombus into the inner wall of the aneurysm. A precise patient-specific segmentation of the thrombus is useful for both the pre-operative planning to estimate the rupture risk, and for post-operative assessment to monitor the disease evolution. This paper presents a generic approach for 3D segmentation of thrombus from patients suffering from AAA using computed tomography angiography (CTA) scans.

Methods

A fast and versatile thrombus segmentation approach has been developed. It is composed of initial centerline detection and aorta lumen segmentation, an optimized pre-processing stage and the use of a 3D deformable model. The approach has been designed to be very generic and requires minimal user interaction. The proposed method was tested on different datasets with 145 patients overall, including pre- and post-operative CTAs, abdominal aorta and iliac artery sections, different calcification degrees, aneurysm sizes and contrast enhancement qualities.

Results

The thrombus segmentation approach showed very accurate results with respect to manual delineations for all datasets (\(\hbox {Dice} = 0.86 \pm 0.06, 0.81 \pm 0.06\) and \(0.87 \pm 0.03\) for abdominal aorta sections on pre-operative CTA, iliac artery sections on pre-operative CTAs and aorta sections on post-operative CTA, respectively). Experiments on the different patient and image conditions showed that the method was highly versatile, with no significant differences in term of precision. Comparison with the level-set algorithm also demonstrated the superiority of the 3D deformable model. Average processing time was \(8.2 \pm 3.5 \hbox { s}\).

Conclusion

We presented a near-automatic and generic thrombus segmentation algorithm applicable to a large variability of patient and imaging conditions. When integrated in an endovascular planning system, our segmentation algorithm shows its compatibility with clinical routine and could be used for pre-operative planning and post-operative assessment of endovascular procedures.

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Authors and Affiliations

  1. Therenva, 4 rue Jean Jaures, 35000, Rennes, France

    Florent Lalys, Vincent Yan & Simon Esneault

  2. Department of Cardiothoracic and Vascular Surgery, CHU Rennes, 35033, Rennes, France

    Adrien Kaladji & Antoine Lucas

Authors
  1. Florent Lalys
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  2. Vincent Yan
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  3. Adrien Kaladji
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  4. Antoine Lucas
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Correspondence to Florent Lalys.

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The authors declare that they have no conflict of interest.

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Lalys, F., Yan, V., Kaladji, A. et al. Generic thrombus segmentation from pre- and post-operative CTA. Int J CARS 12, 1501–1510 (2017). https://doi.org/10.1007/s11548-017-1591-8

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  • DOI: https://doi.org/10.1007/s11548-017-1591-8

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