Computer-aided endovascular aortic repair using fully automated two- and three-dimensional fusion imaging

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• 作者：Giuseppe Panuccio ; MD^a ; ^{giuseppe.panuccio@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Giovanni Federico Torsello ; MD^a ; ^b ; Markus Pfister ; PhD^c ; Theodosios Bisdas ; MD^a ; Michel J. Bosiers ; MD^a ; Giovanni Torsello ; MD^a ; Martin Austermann ; MD^a
• 刊名：Journal of Vascular Surgery
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：64
• 期：6
• 页码：1587-1594.e1
• 全文大小：1693 K

文摘

To assess the usability of a fully automated fusion imaging engine prototype, matching preinterventional computed tomography with intraoperative fluoroscopic angiography during endovascular aortic repair.

Methods

From June 2014 to February 2015, all patients treated electively for abdominal and thoracoabdominal aneurysms were enrolled prospectively. Before each procedure, preoperative planning was performed with a fully automated fusion engine prototype based on computed tomography angiography, creating a mesh model of the aorta. In a second step, this three-dimensional dataset was registered with the two-dimensional intraoperative fluoroscopy. The main outcome measure was the applicability of the fully automated fusion engine. Secondary outcomes were freedom from failure of automatic segmentation or of the automatic registration as well as accuracy of the mesh model, measuring deviations from intraoperative angiography in millimeters, if applicable.

Results

Twenty-five patients were enrolled in this study. The fusion imaging engine could be used in successfully 92% of the cases (n = 23). Freedom from failure of automatic segmentation was 44% (n = 11). The freedom from failure of the automatic registration was 76% (n = 19), the median error of the automatic registration process was 0 mm (interquartile range, 0-5 mm).

Conclusions

The fully automated fusion imaging engine was found to be applicable in most cases, albeit in several cases a fully automated data processing was not possible, requiring manual intervention. The accuracy of the automatic registration yielded excellent results and promises a useful and simple to use technology.