Comparison of 3D computer-aided with manual cerebral aneurysm measurements in different imaging modalities
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DIAGNOSTIC NEURORADIOLOGY
Comparison of 3D computer-aided with manual cerebral aneurysm measurements in different imaging modalities M. Groth & N. D. Forkert & J. H. Buhk & M. Schoenfeld & E. Goebell & J. Fiehler
Received: 22 June 2012 / Accepted: 12 September 2012 / Published online: 25 September 2012 # Springer-Verlag Berlin Heidelberg 2012
Abstract Introduction To compare intra- and inter-observer reliability of aneurysm measurements obtained by a 3D computeraided technique with standard manual aneurysm measurements in different imaging modalities. Methods A total of 21 patients with 29 cerebral aneurysms were studied. All patients underwent digital subtraction angiography (DSA), contrast-enhanced (CE-MRA) and time-of-flight magnetic resonance angiography (TOFMRA). Aneurysm neck and depth diameters were manually measured by two observers in each modality. Additionally, semi-automatic computer-aided diameter measurements were performed using 3D vessel surface models derived from CE- (CE-com) and TOF-MRA (TOF-com) datasets. Bland–Altman analysis (BA) and intra-class correlation coefficient (ICC) were used to evaluate intra- and interobserver agreement. Results BA revealed the narrowest relative limits of intra- and inter-observer agreement for aneurysm neck and depth diameters obtained by TOF-com (ranging Electronic supplementary material The online version of this article (doi:10.1007/s00234-012-1095-8) contains supplementary material, which is available to authorized users. M. Groth (*) : J. H. Buhk : M. Schoenfeld : E. Goebell : J. Fiehler Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany e-mail: [email protected] N. D. Forkert Department of Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
between ±5.3 % and ±28.3 %) and CE-com (ranging between ±23.3 % and ±38.1 %). Direct measurements in DSA, TOF-MRA and CE-MRA showed considerably wider limits of agreement. The highest ICCs were observed for TOF-com and CE-com (ICC values, 0.92 or higher for intra- as well as inter-observer reliability). Conclusion Computer-aided aneurysm measurement in 3D offers improved intra- and inter-observer reliability and a reproducible parameter extraction, which may be used in clinical routine and as objective surrogate end-points in clinical trials. Keywords Intracranial aneurysm . Reliability of results . Computer-assisted image analysis . MRI . DSA
Introduction Different imaging modalities such as conventional catheter angiography, computed tomography (CT) and magnetic resonance angiography (MRA) are commonly used for the detection and evaluation of cerebral aneurysms [1, 2]. Conventional catheter-based digital subtraction angiography (DSA) is still considered the gold standard in clinical practice [3, 4] although it is associated with several drawbacks such as X-ray exposure, complication risks and loss of spatial information due to the 2D projection. Quantitati
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