Feasibility of shear wave sonoelastography to detect endoleak and evaluate thrombus organization after endovascular repair of abdominal aortic aneurysm

Voizard, Nicolas; Bertrand-Grenier, Antony; Alturkistani, Husain; Thérasse, Éric; Tang, An; Kauffmann, Claude; Cloutier, Guy; Soulez, Gilles

doi:10.1007/s00330-020-06739-3

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…It would be desirable, however, to have a quantitative stiffness-based imaging parameter that reliably reflects potential changes of vessel wall properties in smoking and after cessation of smoking 20 , 21 . Evidence exist, that ultrasonographic elastography methods provide additional information on pure morphological information that can be helpful after endovascular repair of aortic aneurysms or in multiparametric vascular ultrasound imaging 22 , 23 . Furthermore, in the last years, 4D-flow and MR elastography have been used to investigate the complex interaction of aortic wall and diameter changes in patients with aneurysm 24 – 26 .…”

Section: Discussionmentioning

confidence: 99%

The effect of smoking on quantification of aortic stiffness by ultrasound time-harmonic elastography

Elgeti

Fröhlich

Wismayer

et al. 2022

Sci Rep

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Smoking is a significant cardiovascular risk factor that causes stiffening of the central arteries, especially the aorta. While vessel stiffness can be determined indirectly by measuring pulse wave velocity, elastography allows image-based determination of vessel stiffness while at the same time providing information on vascular morphology. This study compares abdominal aortic wall stiffness as measured by ultrasound time-harmonic elastography (THE) in fifteen smokers and fifteen age-matched non-smoking controls without a history of cardiovascular disease. Smokers had a significantly higher abdominal aortic wall stiffness with a mean shear wave speed of 2.66 m/s (95% confidence interval (CI) 2.59–2.72 m/s) compared to 2.40 m/s (95% CI 2.34–2.47 m/s) (p < 0.01) in the group of non-smokers. All other baseline characteristics including aortic diameter showed no significant differences. Inter-rater variability was excellent with an intraclass correlation coefficient of 0.99 (95% CI 0.98–0.99). Our results show that THE is sensitive to subclinical stiffening of the aorta in young and middle-aged smokers even before morphological changes occur and may therefore has the potential to serve as a screening tool for early aortic abnormalities and longitudinal risk factors for cardiovascular health.

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Section: Discussionmentioning

confidence: 99%

The effect of smoking on quantification of aortic stiffness by ultrasound time-harmonic elastography

Elgeti

Fröhlich

Wismayer

et al. 2022

Sci Rep

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“…In recent years, endovascular aneurysm repair (EVAR) has become the most common treatment for abdominal aortic aneurysm (AAA) [ 1 , 2 ]. Although EVAR is safer than traditional open repair and is minimally invasive, patients still require long-term follow-up to avoid postinterventional complications [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Unenhanced computed tomography radiomics help detect endoleaks after endovascular repair of abdominal aortic aneurysm

Hu,

Ding,

Wang

et al. 2023

Eur Radiol

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Objectives To explore the feasibility of unenhanced CT images for endoleak detection of abdominal aortic aneurysm (AAA) after endovascular repair (EVAR). Methods Patients who visited our hospital after EVAR from July 2014 to September 2021 were retrospectively collected. Two radiologists evaluated the presence or absence of endoleaks using the combination of contrast-enhanced and unenhanced CT as the referenced standard. After segmenting the aneurysm sac of the unenhanced CT, the radiomic features were automatically extracted from the region of interest. Histogram features of patients with and without endoleak were statistically analyzed to explore the differences between the two groups. Twelve common machine learning (ML) models based on radiomic features were constructed to evaluate the performance of endoleak detection with unenhanced CT images. Results The study included 216 patients (69 ± 8 years; 191 men) with AAA, including 64 patients with endoleaks. A total of 1955 radiomic features of unenhanced CT were extracted. Compared with patients without endoleak, the aneurysm sac outside the stent of patients with endoleak had higher CT attenuation (41.7 vs. 33.6, p < 0.001) with smaller dispersion (51.5 vs. 58.8, p < 0.001). The average area under the curve (AUC) of the ML models constructed with unenhanced CT radiomics was 0.86 ± 0.05, the accuracy was 81% ± 4, the sensitivity was 88% ± 10, and the specificity was 78% ± 5. When fixing the sensitivity to > 90% (92% ± 2), the models retained specificity at 72% ± 10. Conclusions Unenhanced CT features exhibit significant differences between patients with and without endoleak and can help detect endoleaks in AAA after EVAR with high sensitivity. Clinical relevance statement Unenhanced CT radiomics can help provide an alternative method of endoleak detection in patients who have adverse reactions to contrast media. This study further exploits the value of unenhanced CT examinations in the clinical management and surveillance of postoperative abdominal aortic aneurysm. Key Points • Unenhanced CT features of the aneurysm sac outside the stent exhibit significant differences between patients with and without endoleak. The endoleak group showed higher unenhanced CT attenuation (41.7 vs 33.6, p < .001) with smaller dispersion (51.5 vs 58.8, p < .001) than the nonendoleak group. • Unenhanced CT radiomics can help detect endoleaks after intervention. The average area under the curve (AUC) of twelve common machine learning models constructed with unenhanced CT radiomics was 0.86 ± 0.05, the average accuracy was 81% ± 4. • When fixing the sensitivity to > 90% (92% ± 2), the machine learning models retained average specificity at 72% ± 10.

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Strain Ultrasound Elastography of Aneurysm Sac Content after Randomized Endoleak Embolization with Sclerosing vs. Non-sclerosing Chitosan-based Hydrogels in a Canine Model

Sivakumaran

Alturkistani

Lerouge

et al. 2022

Journal of Vascular and Interventional Radiology

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Feasibility of shear wave sonoelastography to detect endoleak and evaluate thrombus organization after endovascular repair of abdominal aortic aneurysm

Cited by 3 publications

References 26 publications

The effect of smoking on quantification of aortic stiffness by ultrasound time-harmonic elastography

The effect of smoking on quantification of aortic stiffness by ultrasound time-harmonic elastography

Unenhanced computed tomography radiomics help detect endoleaks after endovascular repair of abdominal aortic aneurysm

Strain Ultrasound Elastography of Aneurysm Sac Content after Randomized Endoleak Embolization with Sclerosing vs. Non-sclerosing Chitosan-based Hydrogels in a Canine Model

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