Measuring abdominal aortic diameters in routine abdominal computed tomography scans and implications for abdominal aortic aneurysm screening

Claridge, Rachel; Arnold, Samuel R. C.; Morrison, Neil D.; Rij, André M. van

doi:10.1016/j.jvs.2016.11.044

Cited by 29 publications

(33 citation statements)

References 15 publications

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“…Each study was annotated by 1 to 4 CT technologists under supervision of 2 radiologists. Based on the clinical definition [2], the presence of AAA was determined by applying a 3.0 cm threshold to the maximum aortic diameter as defined by the manual segmentations.…”

Section: Primary Data Setmentioning

confidence: 99%

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DeepAAA: Clinically Applicable and Generalizable Detection of Abdominal Aortic Aneurysm Using Deep Learning

Brooks

Hahn

et al. 2019

Lecture Notes in Computer Science

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We propose a deep learning-based technique for detection and quantification of abdominal aortic aneurysms (AAAs). The condition, which leads to more than 10,000 deaths per year in the United States, is asymptomatic, often detected incidentally, and often missed by radiologists. Our model architecture is a modified 3D U-Net combined with ellipse fitting that performs aorta segmentation and AAA detection. The study uses 321 abdominal-pelvic CT examinations performed by Massachusetts General Hospital Department of Radiology for training and validation. The model is then further tested for generalizability on a separate set of 57 examinations with differing patient demographics and acquisition characteristics than the original dataset. DeepAAA achieves high performance on both sets of data (sensitivity/specificity 0.91/0.95 and 0.85 / 1.0 respectively), on contrast and non-contrast CT scans and works with image volumes with varying numbers of images. We find that DeepAAA exceeds literature-reported performance of radiologists on incidental AAA detection. It is expected that the model can serve as an effective background detector in routine CT examinations to prevent incidental AAAs from being missed.

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Section: Primary Data Setmentioning

confidence: 99%

“…As most AAAs are asymptomatic until critical bleeding, incidental finding of AAAs becomes critical. However, on routine abdominal computed tomography (CT) exams, only 65% of AAAs are incidentally identified [2]. This low reporting rate makes it difficult to provide timely intervention for patients.…”

Section: Introductionmentioning

confidence: 99%

DeepAAA: Clinically Applicable and Generalizable Detection of Abdominal Aortic Aneurysm Using Deep Learning

Brooks

Hahn

et al. 2019

Lecture Notes in Computer Science

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“…The mean diameter of the human aorta adjacent to the RAs was approximately 20 mm, approximately twice that of the porcine aorta ( Fig. 7D ) [ 3 , 15 , 31 ]. In general, to deliver treatment catheters such as balloons, stents, and RDN devices to the target position, it is needed to stabilize a guiding catheter (a pathway for the treatment catheters) approaching the target vessel with adequate backup force.…”

Section: Discussionmentioning

confidence: 99%

Quantitative angiographic anatomy of the renal arteries and adjacent aorta in the swine for preclinical studies of intravascular catheterization devices

et al. 2018

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Swine are the most common animal model in preclinical studies of cardiovascular devices. Because of the recent trend for development of new devices for percutaneous catheterization, especially for the renal arteries (RAs), we examined the quantitative anatomical dimensions of the RAs and adjacent aorta in swine. Angiographic images were analyzed in 66 female Yorkshire/Landrace crossbred swine. The diameter of both the right and left main RA was 5.4 ± 0.6 mm. The length of the right main RA was significantly longer than that of the left (29.8 ± 7.5 mm vs. 20.6 ± 5.4 mm, respectively; P<0.001). The diameter of both the right and left branch RA with diameters ≥3 mm (the target vessel diameter of recently developed devices) was 3.8 ± 0.5 mm. The right branch RA was significantly longer than that of the left (18.9 ± 7.8 mm vs. 16.4 ± 7.4 mm, respectively; P<0.05). The branching angle of the right RA from the aorta was significantly smaller than that of the left (91 ± 12° vs. 103 ± 15°, respectively; P<0.001). The diameters of the suprarenal and infrarenal aorta were 10.6 ± 1.1 mm and 9.7 ± 0.9 mm, respectively. In conclusion, because of their similar dimensions to human, swine are an appropriate animal model for assessing the safety of, and determining optimal design of, catheter devices for RAs in simulated clinical use. However, there were species differences in the branching angle and adjacent aorta diameter, suggesting that swine models alone are inadequate to assess the delivery performance of catheter devices for RAs.

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“…Estimating the prevalence of AAA in New Zealand men aged 65 years was difficult given the absence of large population‐based prevalence studies. There have been several smaller AAA prevalence studies in New Zealand between 2005 and 2014. Although they were conducted in different populations and using different imaging modalities, they showed an AAA prevalence in men aged 65 years of between 3 and 8 per cent, particularly in the larger studies that most closely represented a general population.…”

Section: Methodsmentioning

confidence: 99%

Health gains, costs and cost-effectiveness of a population-based screening programme for abdominal aortic aneurysms

Nair

Kvizhinadze

Jones

et al. 2019

British Journal of Surgery

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Background Abdominal aortic aneurysm (AAA) rupture carries a high fatality rate. AAAs can be detected before rupture by abdominal ultrasound imaging, allowing elective repair. Population‐based screening for AAA in older men reduces AAA‐related mortality by about 40 per cent. The UK began an AAA screening programme offering one‐off scans to men aged 65 years in 2009. Sweden has a similar programme. Currently, there is no AAA screening programme in New Zealand. This cost–utility analysis aimed to assess the cost‐effectiveness of a UK‐style screening programme in the New Zealand setting. Methods The analysis compared a formal AAA screening programme (one‐off abdominal ultrasound imaging for about 20 000 men aged 65 years in 2011) with no systematic screening. A Markov macrosimulation model was adapted to estimate the health gains (in quality‐adjusted life‐years, QALYs), health system costs and cost‐effectiveness in New Zealand. A health system perspective and lifetime horizon was adopted. Results With New Zealand‐specific inputs, the adapted model produced an estimate of about NZ $15 300 (€7746) per QALY gained, with a 95 per cent uncertainty interval (UI) of NZ $8700 to 31 000 (€4405 to 15 694) per QALY gained. Health gains were estimated at 117 (95 per cent UI 53 to 212) QALYs. Health system costs were NZ $1·68 million (€850 535), with a 95 per cent UI of NZ $820 200 to 3·24 million (€415 243 to €1·65 million). Conclusion Using New Zealand's gross domestic product per capita (about NZ $45 000 or €22 100) as a cost‐effectiveness threshold, a UK‐style AAA screening programme would be cost‐effective in New Zealand.

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Measuring abdominal aortic diameters in routine abdominal computed tomography scans and implications for abdominal aortic aneurysm screening

Cited by 29 publications

References 15 publications

DeepAAA: Clinically Applicable and Generalizable Detection of Abdominal Aortic Aneurysm Using Deep Learning

DeepAAA: Clinically Applicable and Generalizable Detection of Abdominal Aortic Aneurysm Using Deep Learning

Quantitative angiographic anatomy of the renal arteries and adjacent aorta in the swine for preclinical studies of intravascular catheterization devices

Health gains, costs and cost-effectiveness of a population-based screening programme for abdominal aortic aneurysms

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