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Quantitative analysis of dynamic computed tomography angiography for the detection of endoleaks after abdominal aorta aneurysm endovascular repair: A feasibility study

OBJECTIVES: To assess the feasibility of quantitative analysis of dynamic computed tomography angiography (dCTA) for the detection of endoleaks in patients who underwent endovascular repair of abdominal aortic aneurysms (EVAR). MATERIAL AND METHODS: Twenty patients scheduled for contrast-enhanced CT...

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Autores principales: Apfaltrer, Georg, Lavra, Francesco, Schoepf, U. Joseph, Scarabello, Marco, Yamada, Ricardo, van Assen, Marly, Varga-Szemes, Akos, Jacobs, Brian E., Bauer, Maximilian J., Greenberg, William T., Guimaraes, Marcelo, Saba, Luca, De Cecco, Carlo N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790279/
https://www.ncbi.nlm.nih.gov/pubmed/33411747
http://dx.doi.org/10.1371/journal.pone.0245134
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author Apfaltrer, Georg
Lavra, Francesco
Schoepf, U. Joseph
Scarabello, Marco
Yamada, Ricardo
van Assen, Marly
Varga-Szemes, Akos
Jacobs, Brian E.
Bauer, Maximilian J.
Greenberg, William T.
Guimaraes, Marcelo
Saba, Luca
De Cecco, Carlo N.
author_facet Apfaltrer, Georg
Lavra, Francesco
Schoepf, U. Joseph
Scarabello, Marco
Yamada, Ricardo
van Assen, Marly
Varga-Szemes, Akos
Jacobs, Brian E.
Bauer, Maximilian J.
Greenberg, William T.
Guimaraes, Marcelo
Saba, Luca
De Cecco, Carlo N.
author_sort Apfaltrer, Georg
collection PubMed
description OBJECTIVES: To assess the feasibility of quantitative analysis of dynamic computed tomography angiography (dCTA) for the detection of endoleaks in patients who underwent endovascular repair of abdominal aortic aneurysms (EVAR). MATERIAL AND METHODS: Twenty patients scheduled for contrast-enhanced CT angiography (CTA) of the abdominal aorta post-EVAR were prospectively enrolled. All patients received a standard triphasic CTA protocol, followed by an additional dCTA. The dCTA acquisition enabled reconstruction of color-coded maps depicting blood perfusion and a dCTA dataset of the aneurysm sac. Observers assessed the dCTA and dynamic CT perfusion (dCTP) images for the detection of endoleaks, establishing diagnostic confidence based on a modified 5-point Likert scale. An index was calculated for the ratio between the endoleak and aneurysm sac using blood flow for dCTP and Hounsfield units (HU) for dCTA. The Wilcoxon test compared the endoleak index and the diagnostic confidence of the observers. RESULTS: In total, 19 patients (18 males, median age 74 years [70.5–75.7]) were included for analysis. Nine endoleaks were detected in 7 patients using triphasic CTA as the reference standard. There was complete agreement for endoleak detection between the two techniques on a per-patient basis. Both dCTA and dCTP identified an additional endoleak in one patient. The diagnostic confidence using dCTP for detection of endoleaks was not significantly superior to dCTA (5.0 [5–5] vs. 4.5 [4–5], respectively; p = 0.11); however, dCTP demonstrated superior diagnostic confidence for endoleak exclusion compared to dCTA (1.0 [1–1] vs 1.5 [1.5–1.5], respectively; p <0.01). Moreover, the dCTP endoleak index was significantly higher than the dCTA index (18.5 [10.8–20.5] vs. 3.5 [5–2.7], respectively; p = 0.02). CONCLUSIONS: Quantitative analysis of dCTP imaging can aid in the detection of endoleaks and demonstrates a higher endoleak detection rate than triphasic CTA, as well as a strong correlation with visual assessment of dCTA images.
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spelling pubmed-77902792021-01-14 Quantitative analysis of dynamic computed tomography angiography for the detection of endoleaks after abdominal aorta aneurysm endovascular repair: A feasibility study Apfaltrer, Georg Lavra, Francesco Schoepf, U. Joseph Scarabello, Marco Yamada, Ricardo van Assen, Marly Varga-Szemes, Akos Jacobs, Brian E. Bauer, Maximilian J. Greenberg, William T. Guimaraes, Marcelo Saba, Luca De Cecco, Carlo N. PLoS One Research Article OBJECTIVES: To assess the feasibility of quantitative analysis of dynamic computed tomography angiography (dCTA) for the detection of endoleaks in patients who underwent endovascular repair of abdominal aortic aneurysms (EVAR). MATERIAL AND METHODS: Twenty patients scheduled for contrast-enhanced CT angiography (CTA) of the abdominal aorta post-EVAR were prospectively enrolled. All patients received a standard triphasic CTA protocol, followed by an additional dCTA. The dCTA acquisition enabled reconstruction of color-coded maps depicting blood perfusion and a dCTA dataset of the aneurysm sac. Observers assessed the dCTA and dynamic CT perfusion (dCTP) images for the detection of endoleaks, establishing diagnostic confidence based on a modified 5-point Likert scale. An index was calculated for the ratio between the endoleak and aneurysm sac using blood flow for dCTP and Hounsfield units (HU) for dCTA. The Wilcoxon test compared the endoleak index and the diagnostic confidence of the observers. RESULTS: In total, 19 patients (18 males, median age 74 years [70.5–75.7]) were included for analysis. Nine endoleaks were detected in 7 patients using triphasic CTA as the reference standard. There was complete agreement for endoleak detection between the two techniques on a per-patient basis. Both dCTA and dCTP identified an additional endoleak in one patient. The diagnostic confidence using dCTP for detection of endoleaks was not significantly superior to dCTA (5.0 [5–5] vs. 4.5 [4–5], respectively; p = 0.11); however, dCTP demonstrated superior diagnostic confidence for endoleak exclusion compared to dCTA (1.0 [1–1] vs 1.5 [1.5–1.5], respectively; p <0.01). Moreover, the dCTP endoleak index was significantly higher than the dCTA index (18.5 [10.8–20.5] vs. 3.5 [5–2.7], respectively; p = 0.02). CONCLUSIONS: Quantitative analysis of dCTP imaging can aid in the detection of endoleaks and demonstrates a higher endoleak detection rate than triphasic CTA, as well as a strong correlation with visual assessment of dCTA images. Public Library of Science 2021-01-07 /pmc/articles/PMC7790279/ /pubmed/33411747 http://dx.doi.org/10.1371/journal.pone.0245134 Text en © 2021 Apfaltrer et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Apfaltrer, Georg
Lavra, Francesco
Schoepf, U. Joseph
Scarabello, Marco
Yamada, Ricardo
van Assen, Marly
Varga-Szemes, Akos
Jacobs, Brian E.
Bauer, Maximilian J.
Greenberg, William T.
Guimaraes, Marcelo
Saba, Luca
De Cecco, Carlo N.
Quantitative analysis of dynamic computed tomography angiography for the detection of endoleaks after abdominal aorta aneurysm endovascular repair: A feasibility study
title Quantitative analysis of dynamic computed tomography angiography for the detection of endoleaks after abdominal aorta aneurysm endovascular repair: A feasibility study
title_full Quantitative analysis of dynamic computed tomography angiography for the detection of endoleaks after abdominal aorta aneurysm endovascular repair: A feasibility study
title_fullStr Quantitative analysis of dynamic computed tomography angiography for the detection of endoleaks after abdominal aorta aneurysm endovascular repair: A feasibility study
title_full_unstemmed Quantitative analysis of dynamic computed tomography angiography for the detection of endoleaks after abdominal aorta aneurysm endovascular repair: A feasibility study
title_short Quantitative analysis of dynamic computed tomography angiography for the detection of endoleaks after abdominal aorta aneurysm endovascular repair: A feasibility study
title_sort quantitative analysis of dynamic computed tomography angiography for the detection of endoleaks after abdominal aorta aneurysm endovascular repair: a feasibility study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790279/
https://www.ncbi.nlm.nih.gov/pubmed/33411747
http://dx.doi.org/10.1371/journal.pone.0245134
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