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Updated: Jun 29, 2026
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Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging
Published on: December 9, 2021
Intra- and interobserver variability of aortic aneurysm volume measurement with fast CTA postprocessing software
Joffrey van Prehn1, Martijn B A van der Wal, Koen Vincken
1Department of Vascular Surgery, University Medical Center Utrecht, The Netherlands. J.Prehn@umcutrecht.nl
Summary
A new semi-automatic method for measuring aortic aneurysm volume shows good consistency between and within observers. This fast method aligns with standard techniques, supporting its clinical use for endovascular aneurysm repair (EVAR) follow-up.
Area of Science:
- Medical Imaging
- Vascular Surgery
- Quantitative Analysis
Background:
- Accurate measurement of abdominal aortic aneurysm (AAA) sac volume is crucial for monitoring treatment effectiveness after endovascular aneurysm repair (EVAR).
- Traditional manual methods for volume assessment can be time-consuming and subject to observer variability.
- Development of faster, reliable methods is essential for routine clinical application.
Purpose of the Study:
- To evaluate the inter- and intraobserver variability of a novel, rapid semi-automatic method for AAA volume measurement.
- To compare the accuracy and consistency of the semi-automatic method against a validated standard manual technique.
- To assess the suitability of the semi-automatic method for clinical follow-up of EVAR patients.
Main Methods:
- Twenty abdominal computed tomographic angiography (CTA) datasets (10 pre-EVAR, 10 post-EVAR) were analyzed.
- Two independent observers measured AAA sac volumes using both the standard manual method and the new semi-automatic method.
- Intra- and interobserver variability were quantified using Bland-Altman analysis, calculating mean differences and repeatability coefficients (RC).
Main Results:
- The semi-automatic method demonstrated low intraobserver variability (RC: 7.8 mL) and acceptable interobserver variability (RC: 10.8 mL).
- Variability between the semi-automatic and standard manual methods was higher (RCs: 25.1 mL and 21.3 mL for observers 1 and 2, respectively).
- Despite differences, the semi-automatic method's results are comparable to the standard method, maintaining the 5% cutoff for relevant volume changes in EVAR follow-up.
Conclusions:
- The semi-automatic method offers good intra- and interobserver reliability for AAA volume assessment pre- and post-EVAR.
- This fast, sophisticated software facilitates clinical adoption of volume measurements in daily practice.
- The method's precision supports current EVAR reporting standards for monitoring relevant volume changes.