An adaptive optimal viewing angle determination algorithm for TEVAR operation

Background The determination of the right x-ray angiography viewing angle is an important issue during the treatment of thoracic endovascular aortic repair (TEVAR). An inaccurate projection angle (manually determined today by the physicians according to their personal experience) may affect the plac...

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Veröffentlicht in:BMC medical imaging Jg. 21; H. 1; S. 141 - 9
Hauptverfasser: Sun, Weiya, Yang, Guanyu, Chen, Yang, Shu, Huazhong
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London BioMed Central 02.10.2021
BioMed Central Ltd
Springer Nature B.V
BMC
Schlagworte:
Adaptive algorithms
Algorithms
Aneurysm, Dissecting - diagnostic imaging
Aneurysm, Dissecting - surgery
Angiography
Aorta
Aorta, Thoracic - diagnostic imaging
Aorta, Thoracic - surgery
Aortic Aneurysm, Thoracic - diagnostic imaging
Aortic Aneurysm, Thoracic - surgery
Aortic dissection
Aortography - methods
Cardiovascular system
Carotid artery
Computed tomography
Computed tomography angiography
Computed Tomography Angiography - methods
Coronary vessels
CT imaging
Endovascular Procedures - methods
Female
Humans
Image acquisition
Imaging
Implants
Low-dose
Male
Mathematical optimization
Medical imaging
Medical personnel
Medicine
Medicine & Public Health
Middle Aged
Morphology
Occlusion
Optimization
Optimum viewing angle
Patients
Physicians
Radiation
Radiation effects
Radiology
Stent (Surgery)
Stents
Subclavian Artery - diagnostic imaging
Thorax
Veins & arteries
Viewing
X-ray
Germany
Computed tomography angiography
Low-dose
Aortic dissection
X-ray
Optimum viewing angle
ISSN:1471-2342, 1471-2342
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Zusammenfassung:Background The determination of the right x-ray angiography viewing angle is an important issue during the treatment of thoracic endovascular aortic repair (TEVAR). An inaccurate projection angle (manually determined today by the physicians according to their personal experience) may affect the placement of the stent and cause vascular occlusion or endoleak. Methods Based on the acquisition of a computed tomography angiography (CTA) image before TEVAR, an adaptive optimization algorithm is proposed to determine the optimal viewing angle of the angiogram automatically. This optimal view aims at avoiding any overlapping between the left common carotid artery and the left subclavian artery. Moreover, the proposed optimal procedure exploits the patient-specific morphology to adaptively reduce the potential foreshortening effect. Results Experimental results conducted on thirty-five patients demonstrate that the optimal angiographic viewing angle based on the proposed method has no significant difference when compared with the expert practice ( p  = 0.0678). Conclusion We propose a method that utilizes the CTA image acquired before TEVAR to automatically calculate the optimal C-arm angle. This method has the potential to assist surgeons during their interventional procedure by providing a shorter procedure time, less radiation exposure, and less contrast injection.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1471-2342
1471-2342
DOI:10.1186/s12880-021-00676-3