In-silico analysis of curve fitting in angiographic parametric imaging in intracranial aneurysms to reduce patient and interventionalist-induced errors

Abstract

In Angiographic Parametric Imaging (API), accurate estimation of parameters from Time Density Curves (TDC) is crucial. However, these estimations are often marred by errors arising from factors such as patient motion, image noise, and injection variability. While fitting methods like gamma-variate fitting offer a solution to recover incomplete or corrupted TDC data, they might also introduce unforeseen biases. This study investigates the trade-offs and benefits of employing gamma-variate fitting on virtual angiograms to enhance the precision of API biomarkers. Utilizing Computational Fluid Dynamics (CFD) in patient specific 3D geometries, we generated a series of high-definition virtual angiograms at distinct inlet velocities: 0.25m/s, 0.35m/s, and 0.45m/s. These velocities were investigated across injection durations ranging from 0.5s to 2.0s. From these angiograms, TDCs for aneurysms and their corresponding inlets were constructed. We generated a perfect injection function and convolved with it with the Impulse Residue Function (IRF), to get a TDC of the aneurysm dome. To emulate typical clinical challenges, we introduced noise, simulated patient motion, and generated temporally incomplete data sets. These modified TDCs underwent gamma-variate fitting. We quantified both the ideal, non-gamma fitted and fitted TDC curves using standard angiography metrics such as Cross-Correlation (Cor), Time to Peak (TTP), Mean Transit Time (MTT), Peak Height (PH), Area Under the Curve (AUC), and Maximum Gradient (Max-Gr) for a comprehensive comparison. TDCs enhanced by gamma-variate fitting exhibited a robust correlation with vascular flow dynamics. Our results affirm that gamma-variate fitting can adeptly restore TDCs from fragmentary sequences, elevating the precision of derived API parameters. Incorporating gamma-variate fitting into TDCs analysis augments the precision and robustness of API parameters, bolstering the credibility of neurovascular diagnostic procedures.