Advantages of 3D registration technology (3DRT) in clinical application of unruptured intracranial aneurysm follow-up: A novel method to judge aneurysm growth

J Neuroradiol. 2023 Mar;50(2):209-216. doi: 10.1016/j.neurad.2022.08.004. Epub 2022 Aug 28.

Abstract

Background and purpose: Currently available methods for determining aneurysm growth are not accurate enough. Therefore, we introduced a more intuitive and accurate 3D registration technology (3DRT) to judge the growth of aneurysms.

Materials and methods: We developed an in-house technique for 3DRT and calculated its derivative parameters, voxel change rate (VCR), maximum growth vector (MGV), and parent artery coincidence (PAC). To verify the accuracy, growing aneurysms and stable aneurysms matching 1:3 were selected, and a 3DRT measurement was performed. We calculated the sensitivity, specificity, and accuracy of cases with VCR > 20%, MGV > 1 mm, and combined indicator of VCR > 20% + MGV >1 mm. In addition, we analyzed the cause of the poor registration effect, where the registration effect of PAC > 0.7 was considered acceptable. We also collected 24 consecutive aneurysms for agreement analysis of 2D manual measurement and 3DRT.

Results: Twenty-seven growing aneurysms and 81 stable aneurysms were included in the normal model group, and 88 aneurysms with good registration effect in the adjusted model group. For aneurysms with VCR > 20%, the sensitivity and the specificity were the highest at 81.48% and 91.35%, respectively, while in the adjusted model group, the sensitivity and the specificity increased to 94.44% and 94.29%, respectively. When using VCR > 20% as the growth metric, the AUC value in the normal and the adjusted model group was 0.856 and 0.947, respectively. The ICC between 2D manual measurements and the 3DRT was 0.95 (95%CI: 0.88-0.98), and the time spent between the two groups had a significant difference (10.96 min vs. 3.44 min, p<0.01, 95% CI, 6.49-8.53).

Conclusions: A 3DRT can be used to determine the growth of the aneurysm more efficiently, intuitively, and accurately.

Keywords: 3DRT; Aneurysm growth; Maximum growth vector; Voxel change rate.

MeSH terms

  • Aneurysm, Ruptured*
  • Humans
  • Intracranial Aneurysm*