Pre-surgical and Post-surgical Aortic Aneurysm Maximum Diameter Measurement: Full Automation by Artificial Intelligence

Eur J Vasc Endovasc Surg. 2021 Dec;62(6):869-877. doi: 10.1016/j.ejvs.2021.07.013. Epub 2021 Sep 10.

Abstract

Objective: The aim of this study was to evaluate an automatic, deep learning based method (Augmented Radiology for Vascular Aneurysm [ARVA]), to detect and assess maximum aortic diameter, providing cross sectional outer to outer aortic wall measurements.

Methods: Accurate external aortic wall diameter measurement is performed along the entire aorta, from the ascending aorta to the iliac bifurcations, on both pre- and post-operative contrast enhanced computed tomography angiography (CTA) scans. A training database of 489 CTAs was used to train a pipeline of neural networks for automatic external aortic wall measurements. Another database of 62 CTAs, including controls, aneurysmal aortas, and aortic dissections scanned before and/or after endovascular or open repair, was used for validation. The measurements of maximum external aortic wall diameter made by ARVA were compared with those of seven clinicians on this validation dataset.

Results: The median absolute difference with respect to expert's measurements ranged from 1 mm to 2 mm among all annotators, while ARVA reported a median absolute difference of 1.2 mm.

Conclusion: The performance of the automatic maximum aortic diameter method falls within the interannotator variability, making it a potentially reliable solution for assisting clinical practice.

Keywords: Aortic aneurysm; Automatic measurements; Deep learning; Outer to outer wall diameters; Pre-operative/post-operative CT scans.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal / diagnostic imaging*
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortography*
  • Automation
  • Computed Tomography Angiography*
  • Databases, Factual
  • Deep Learning
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neural Networks, Computer*
  • Predictive Value of Tests
  • Radiographic Image Interpretation, Computer-Assisted*
  • Reproducibility of Results
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult