Clinical Evaluation of an Innovative Metal-Artifact-Reduction Algorithm in FD-CT Angiography in Cerebral Aneurysms Treated by Endovascular Coiling or Surgical Clipping

Diagnostics

Michael Manhart¹  Felix Eisenhut²  Stefan Lang²  Arnd Doerfler²  Tobias Struffert²  Alexander Kalik²  Manuel Alexander Schmidt²  Julian Feulner³  Sven-Martin Schlaffer³ 

[1] Advanced Therapies, Innovation, Siemens Healthcare GmbH, Siemensstraße 1, 91301 Forchheim, Germany;Department of Neuroradiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Schwabachanlage 6, 91054 Erlangen, Germany;Department of Neurosurgery, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany;

关键词: cerebral aneurysm;    endovascular coiling;    flat-detector computed tomography angiography;    metal-artifact-reduction algorithm;    surgical clipping;   

DOI  :  10.3390/diagnostics12051140

来源: DOAJ

【 摘 要 】

Treated cerebral aneurysms (IA) require follow-up imaging to ensure occlusion. Metal artifacts complicate radiologic assessment. Our aim was to evaluate an innovative metal-artifact-reduction (iMAR) algorithm for flat-detector computed tomography angiography (FD-CTA) regarding image quality (IQ) and detection of aneurysm residua/reperfusion in comparison to 2D digital subtraction angiography (DSA). Patients with IAs treated by endovascular coiling or clipping underwent both FD-CTA and DSA. FD-CTA datasets were postprocessed with/without iMAR algorithm (MAR+/MAR−). Evaluation of all FD-CTA and DSA datasets regarding qualitative (IQ, MAR) and quantitative (coil package diameter/CPD) parameters was performed. Aneurysm occlusion was assessed for each dataset and compared to DSA findings. In total, 40 IAs were analyzed (n_coiling = 24; n_clipping = 16). All iMAR+ datasets demonstrated significantly better IQ (p_IQ coiling < 0.0001; p_IQ clipping < 0.0001). iMAR significantly reduced the metal-artifact burden but did not affect the CPD. iMAR significantly improved the detection of aneurysm residua/reperfusion with excellent agreement with DSA (n_{aneurysm detection MAR+/MAR−/DSA} = 22/1/26). The iMAR algorithm significantly improves IQ by effective reduction of metal artifacts in FD-CTA datasets. The proposed algorithm enables reliable detection of aneurysm residua/reperfusion with good agreement to DSA. Thus, iMAR can help to reduce the need for invasive follow-up in treated IAs.

【 授权许可】

Unknown