Development of a statistical model for discrimination of rupture status in posterior communicating artery aneurysms

Detmer, Felicitas J.; Chung, Bong Jae; Mut, Fernando; Pritz, Michael B.; Slawski, Martin; Hamzei-Sichani, Farid; Kallmes, David F.; Putman, Christopher M.; Jimenez, Carlos; Cebral, Juan R.

doi:10.1007/s00701-018-3595-8

Cited by 14 publications

(8 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Specifically, the consideration of adjacent side branches and an appropriate reconstruction of the aneurysm neck, as well as morphological features such as blebs or daughter aneurysms, is crucial. Only then can large-scale studies containing high numbers of cases advance the knowledge of neurovascular diseases [32,33]. 2) During the analysis of clinically relevant morphological and hemodynamic parameters, it was found that these parameters are highly sensitive to the choice of the aneurysm ostium and neck curve, respectively.…”

Section: Discussionmentioning

confidence: 99%

Multiple Aneurysms AnaTomy CHallenge 2018 (MATCH)—Phase Ib: Effect of morphology on hemodynamics

et al. 2019

View full text Add to dashboard Cite

Background Image-based blood flow simulations have been increasingly applied to investigate intracranial aneurysm (IA) hemodynamics. However, the acceptance among physicians remains limited due to the high variability in the underlying assumptions and quality of results. Methods To evaluate the vessel segmentation as one of the most important sources of error, the international Multiple Aneurysms AnaTomy CHallenge 2018 (MATCH) was announced. 26 research groups from 13 different countries segmented three datasets, which contained five IAs in total. Based on these segmentations, 73 time-dependent blood flow simulations under consistent conditions were carried out. Afterwards, relevant flow and shear parameters (e.g., neck inflow rate, parent vessel flow rate, spatial mean velocity, and wall shear stress) were analyzed both qualitatively and quantitatively. Results Regarding the entire vasculature, the variability of the segmented vessel radius is 0.13 mm, consistent and independent of the local vessel radius. However, the centerline velocity shows increased variability in more distal vessels. Focusing on the aneurysms, clear differences in morphological and hemodynamic parameters were observed. The quantification of the segmentation-induced variability showed approximately a 14% difference among the groups for the parent vessel flow rate. Regarding the mean aneurysmal velocity and the neck inflow rate, a variation of 30% and 46% was observed, respectively. Finally, time-averaged wall shear stresses varied between 28% and 51%, depending on the aneurysm in question. Conclusions MATCH reveals the effect of state-of-the-art segmentation algorithms on subsequent hemodynamic simulations for IA research. The observed variations may lead to an inappropriate interpretation of the simulation results and thus, can lead to inappropriate conclusions by physicians. Therefore, accurate segmentation of the region of interest is necessary to obtain reliable and clinically helpful flow information.

show abstract

Section: Discussionmentioning

confidence: 99%

Multiple Aneurysms AnaTomy CHallenge 2018 (MATCH)—Phase Ib: Effect of morphology on hemodynamics

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Meng et al (77) proposed a unifying theory, noting that high WSS combined with a positive WSS gradient leads to growth and rupture of small or secondary bleb aneurysms, while low WSS and high OSI lead to growth and rupture of large atherosclerotic aneurysms. Current studies involving hundreds of patients in which CFD results are combined with morphological data and medical history are leading to the development of clinical tools for aneurysm risk stratification (69,108,155).…”

Section: Translational Value Of Hemodynamic Datamentioning

confidence: 99%

Hemodynamics of Cerebral Aneurysms: Connecting Medical Imaging and Biomechanical Analysis

Rayz

Cohen-Gadol

2020

Annu. Rev. Biomed. Eng.

View full text Add to dashboard Cite

In the last two decades, numerous studies have conducted patient-specific computations of blood flow dynamics in cerebral aneurysms and reported correlations between various hemodynamic metrics and aneurysmal disease progression or treatment outcomes. Nevertheless, intra-aneurysmal flow analysis has not been adopted in current clinical practice, and hemodynamic factors usually are not considered in clinical decision making. This review presents the state of the art in cerebral aneurysm imaging and image-based modeling, discussing the advantages and limitations of each approach and focusing on the translational value of hemodynamic analysis. Combining imaging and modeling data obtained from different flow modalities can improve the accuracy and fidelity of resulting velocity fields and flow-derived factors that are thought to affect aneurysmal disease progression. It is expected that predictive models utilizing hemodynamic factors in combination with patient medical history and morphological data will outperform current risk scores and treatment guidelines. Possible future directions include novel approaches enabling data assimilation and multimodality analysis of cerebral aneurysm hemodynamics.

show abstract

“…The present study investigated the uncertainty of individual geometric rupture risk parameters only. Uncertainty of complex rupture risk models including interactions between two or more geometric risk parameters, such as proposed by Prestigiacomo et al [ 38 ] or Detmer et al [ 39 ], for example, was not investigated. However, all dimensionless parameters investigated here are combinations of two single rupture risk parameters and all data necessary to assess the uncertainty of other complex geometric rupture risk models is provided.…”

Section: Discussionmentioning

confidence: 99%

Multiple Aneurysms AnaTomy CHallenge 2018 (MATCH): uncertainty quantification of geometric rupture risk parameters

et al. 2019

View full text Add to dashboard Cite

BackgroundGeometric parameters have been proposed for prediction of cerebral aneurysm rupture risk. Predicting the rupture risk for incidentally detected unruptured aneurysms could help clinicians in their treatment decision. However, assessment of geometric parameters depends on several factors, including the spatial resolution of the imaging modality used and the chosen reconstruction procedure. The aim of this study was to investigate the uncertainty of a variety of previously proposed geometric parameters for rupture risk assessment, caused by variability of reconstruction procedures.Materials26 research groups provided segmentations and surface reconstructions of five cerebral aneurysms as part of the Multiple Aneurysms AnaTomy CHallenge (MATCH) 2018. 40 dimensional and non-dimensional geometric parameters, describing aneurysm size, neck size, and irregularity of aneurysm shape, were computed. The medians as well as the absolute and relative uncertainties of the parameters were calculated. Additionally, linear regression analysis was performed on the absolute uncertainties and the median parameter values.ResultsA large variability of relative uncertainties in the range between 3.9 and 179.8% was found. Linear regression analysis indicates that some parameters capture similar geometric aspects. The lowest uncertainties < 6% were found for the non-dimensional parameters isoperimetric ratio, convexity ratio, and ellipticity index. Uncertainty of 2D and 3D size parameters was significantly higher than uncertainty of 1D parameters. The most extreme uncertainties > 80% were found for some curvature parameters.ConclusionsUncertainty analysis is essential on the road to clinical translation and use of rupture risk prediction models. Uncertainty quantification of geometric rupture risk parameters provided by this study may help support development of future rupture risk prediction models.Electronic supplementary materialThe online version of this article (10.1186/s12938-019-0657-y) contains supplementary material, which is available to authorized users.

show abstract

Development of a statistical model for discrimination of rupture status in posterior communicating artery aneurysms

Cited by 14 publications

References 37 publications

Multiple Aneurysms AnaTomy CHallenge 2018 (MATCH)—Phase Ib: Effect of morphology on hemodynamics

Multiple Aneurysms AnaTomy CHallenge 2018 (MATCH)—Phase Ib: Effect of morphology on hemodynamics

Hemodynamics of Cerebral Aneurysms: Connecting Medical Imaging and Biomechanical Analysis

Multiple Aneurysms AnaTomy CHallenge 2018 (MATCH): uncertainty quantification of geometric rupture risk parameters

Contact Info

Product

Resources

About