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How Precise Are Preinterventional Measurements Using Centerline Analysis Applications? Objective Ground Truth
Philipp Hoegen1,2, Stefan Wörz3, Matthias Müller-Eschner1,4
11 Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany.
Summary
Realistic aortic aneurysm phantoms were used to evaluate centerline analysis software. Findings reveal significant errors in diameter and length measurements, impacting clinical decisions for endovascular aneurysm repair.
Area of Science:
- Medical imaging analysis
- Computational anatomy
- Vascular surgery planning
Background:
- Accurate centerline analysis of aortic aneurysms is crucial for endovascular repair planning.
- Previous validation studies using in vivo data lack precise ground truth for geometric dimensions.
- Objective validation is needed to assess the accuracy of various centerline analysis software applications.
Purpose of the Study:
- To evaluate the accuracy of different centerline analysis software applications.
- To establish objective ground truth using realistic aortic aneurysm phantoms with defined geometry.
- To overcome limitations of previous in vivo validation studies lacking true dimensional data.
Main Methods:
- Three-dimensional (3D) printing of realistic aortic aneurysm phantoms based on CAD models.
- Acquisition of computed tomography angiograms (CTAs) for phantoms and three patients.
- Analysis using three clinically approved and one research software application for centerline extraction, diameter, and length measurements.
- Validation against CAD ground truth using a dedicated software platform.
Main Results:
- Mean 3D centerline position errors ranged from 0.7±0.8 mm to 2.9±2.5 mm.
- Diameter measurement errors varied, with one application showing significant distortion (exceeding 8.0±11.0 mm).
- Commercially available software underestimated total centerline lengths (-4.6±0.9 mm to -10.4±4.3 mm).
- Higher 3D centerline accuracy correlated with more precise diameter and length measurements.
Conclusions:
- One clinically approved application lacked reproducible results.
- Another approved application exhibited length errors potentially affecting stent-graft selection and procedural outcomes.
- Thorough scientific evaluation and user awareness of endovascular aneurysm repair planning software characteristics are essential.
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