Interobserver variability of aneurysm morphology: discrimination of the daughter sac

Suh, Sang Hyun; Cloft, Harry J.; Huston, John; Han, Kyunghwa; Kallmes, David F.

doi:10.1136/neurintsurg-2014-011471

Cited by 21 publications

(15 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…19 In our study, everything else than a smooth sIA surface on the angiogram in any projection was defined as being irregular, as well as a clearly bi-or multilobular shape, which is a robust and simple definition. The angiograms in our institution are and have been interpreted by a small group of dedicated angiologists and vascular neurosurgeons during the whole study period, reducing variability, as demonstrated by excellent Cohen κ values for inter-and intraobserver variability (>0.80).…”

Section: Limitationsmentioning

confidence: 99%

Irregular Shape of Intracranial Aneurysm Indicates Rupture Risk Irrespective of Size in a Population-Based Cohort

Lindgren

Koivisto

Björkman

et al. 2016

Stroke

169

View full text Add to dashboard Cite

Larger size increased the risk of rupture also in the Japanese (Unruptured Cerebral Aneurysm Study [UCAS]) and Finnish natural history studies. 5,7 Observational studies, however, demonstrate that a significant portion of those sIAs that ruptured did so Background and Purpose-Size and shape of saccular intracranial aneurysms (sIA) reflect the condition of the sIA wall and were risk factors for rupture in previous follow-up studies. We investigated how well size or shape identify ruptureprone sIAs. Methods-In a population-based registry, we investigated the characteristics of ruptured sIAs treated in a single neurosurgical center . In addition to univariate analysis, logistic regression was used in multivariate analysis, and sensitivity and specificity of size or shape were calculated using receiver operating characteristic curves. Results-Ruptured sIAs were on average larger than unruptured sIAs (median, 7 versus 4 mm; P<0.000), but location and patient background affected the size at rupture. Of the ruptured sIAs, 38% were smaller than 7 mm and 18% were smaller than 4 mm. Of those sIAs that had ruptured at a small (<7 mm) size, 87% had an irregular shape. In multivariate analysis, irregular shape had the strongest association with presentation as ruptured sIA (odds ratio, 7.1; 95% confidence interval, 6.0-8.3), with better sensitivity (91%) and specificity (76%), in contrast to smoking (odds ratio, 0.7; 95% confidence interval, 0.6-0.9; sensitivity, 28%; specificity 57%) and Population, Hypertension, Age, Size of sIA, Earlier SAH from another sIA, Site of sIA score (odds ratio, 1.5; 95% confidence interval, 1.4-1.6). Conclusions-Irregular

show abstract

Section: Limitationsmentioning

confidence: 99%

Irregular Shape of Intracranial Aneurysm Indicates Rupture Risk Irrespective of Size in a Population-Based Cohort

Lindgren

Koivisto

Björkman

et al. 2016

Stroke

169

View full text Add to dashboard Cite

show abstract

“…Another limitation is the fact that there is wide interobserver and intraobserver variability in assessments of aneurysm geometric irregularities such as dome-to-neck ratio, lobularity, and the presence of daughter sacs. 26 The core laboratory in this study assessed angiographic recurrence but did not assess aneurysm morphology. Last, we did not study differences in packing attenuation between groups.…”

Section: Discussionmentioning

confidence: 99%

HydroCoils Are Associated with Lower Angiographic Recurrence Rates Than Are Bare Platinum Coils in Treatment of “Difficult-to-Treat” Aneurysms: A Post Hoc Subgroup Analysis of the HELPS Trial

Brinjikji

White

Nahser

et al. 2015

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

“…However, manual measurements have inherent limitations of subjectivity and inconsistency, which cause intra-and interobserver variations 28 and cannot capture the complex geometric features of aneurysms. 29 Researchers have introduced several computerized procedures to make morphology assessment more objective and consistent. [30][31][32] The detection of the neck plane is the key point for multiple subsequent operations.…”

Section: Ai In the Prediction Of Intracranial Aneurysm Rupture Riskmentioning

confidence: 99%

Artificial Intelligence in the Management of Intracranial Aneurysms: Current Status and Future Perspectives

Shi

Schoepf

et al. 2020

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

Intracranial aneurysms with subarachnoid hemorrhage lead to high morbidity and mortality. It is of critical importance to detect aneurysms, identify risk factors of rupture, and predict treatment response of aneurysms to guide clinical interventions. Artificial intelligence has received worldwide attention for its impressive performance in image-based tasks. Artificial intelligence serves as an adjunct to physicians in a series of clinical settings, which substantially improves diagnostic accuracy while reducing physicians' workload. Computerassisted diagnosis systems of aneurysms based on MRA and CTA using deep learning have been evaluated, and excellent performances have been reported. Artificial intelligence has also been used in automated morphologic calculation, rupture risk stratification, and outcomes prediction with the implementation of machine learning methods, which have exhibited incremental value. This review summarizes current advances of artificial intelligence in the management of aneurysms, including detection and prediction. The challenges and future directions of clinical implementations of artificial intelligence are briefly discussed. ABBREVIATIONS: AI¼ artificial intelligence; AUC ¼ area under the curve; CAD ¼ computer-assisted diagnostics; DL ¼ deep learning; FP ¼ false-positive; ML ¼ machine learning; SVM ¼ support vector machines

show abstract

Interobserver variability of aneurysm morphology: discrimination of the daughter sac

Abstract: For discrimination of the daughter sac, the UCAS definition showed a higher reliability than the ISUIA. However, a further prospective study is necessary to validate this definition as the treatment standard for unruptured intracranial aneurysms.

Cited by 21 publications

References 9 publications

Irregular Shape of Intracranial Aneurysm Indicates Rupture Risk Irrespective of Size in a Population-Based Cohort

Irregular Shape of Intracranial Aneurysm Indicates Rupture Risk Irrespective of Size in a Population-Based Cohort

HydroCoils Are Associated with Lower Angiographic Recurrence Rates Than Are Bare Platinum Coils in Treatment of “Difficult-to-Treat” Aneurysms: A Post Hoc Subgroup Analysis of the HELPS Trial

Artificial Intelligence in the Management of Intracranial Aneurysms: Current Status and Future Perspectives

Contact Info

Product

Resources

About