Separating the wheat from the chaff

Region of interest combined with metal artifact reduction for completion angiography following cerebral aneurysm treatment

Edward A.M. Duckworth, Chris Nickele, Sebastian Schafer, Sebastian Bauer, Bernhard Scholz, Lucas Elijovich, Daniel Hoit, Vinodh T. Doss, Adam Arthur

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction Following complicated endovascular or microsurgical treatments, assessment of radiographic outcome can be challenging due to device resolution and metallic artifact. Two-dimensional and three-dimensional angiography can reveal information about flow and aneurysm obliteration, but may be limited by beam hardening, overlapping vessels, and image degradation in the region of metallic implants. In this study, we investigated the combination of a collimated volumetric imaging (volume of interest, VOI) protocol followed by metal artifact reduction (MAR) post-processing to evaluate the correct positioning of stents, flow diverters, coils, and clips while limiting the radiation dose to the patient. Methods 9 patients undergoing 10 procedures were included in our study. All patients underwent endovascular or surgical treatment of a cerebral aneurysm involving stents, flow diverting stents, coils, and/or clips followed by either immediate or early postoperative evaluation of our protocol. Results Image datasets corrected for metallic artifacts (VOI-MAR) were judged to be better - a statistically significant finding - than image datasets only corrected for field of view truncation (VOI alone). Qualitatively, images were more interpretable and informative with regards to device position and apposition to the vessel wall for those cases involving a pipeline, and with regards to encroachment on the parent artery and possible residual aneurysm, in all cases. Conclusions VOI acquisition combined with MAR post-processing provides for accurate and informative evaluation of cerebral aneurysm treatment while limiting the radiation dose to patients.

Original languageEnglish (US)
Pages (from-to)1163-1167
Number of pages5
JournalJournal of NeuroInterventional Surgery
Volume8
Issue number11
DOIs
StatePublished - Nov 1 2016

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Intracranial Aneurysm
Artifacts
Angiography
Metals
Stents
Surgical Instruments
Aneurysm
Radiation
Therapeutics
Equipment and Supplies
Arteries
Outcome Assessment (Health Care)
Datasets

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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Separating the wheat from the chaff : Region of interest combined with metal artifact reduction for completion angiography following cerebral aneurysm treatment. / Duckworth, Edward A.M.; Nickele, Chris; Schafer, Sebastian; Bauer, Sebastian; Scholz, Bernhard; Elijovich, Lucas; Hoit, Daniel; Doss, Vinodh T.; Arthur, Adam.

In: Journal of NeuroInterventional Surgery, Vol. 8, No. 11, 01.11.2016, p. 1163-1167.

Research output: Contribution to journalArticle

Duckworth, Edward A.M. ; Nickele, Chris ; Schafer, Sebastian ; Bauer, Sebastian ; Scholz, Bernhard ; Elijovich, Lucas ; Hoit, Daniel ; Doss, Vinodh T. ; Arthur, Adam. / Separating the wheat from the chaff : Region of interest combined with metal artifact reduction for completion angiography following cerebral aneurysm treatment. In: Journal of NeuroInterventional Surgery. 2016 ; Vol. 8, No. 11. pp. 1163-1167.
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