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Stent Graft Sizing for Endovascular Abdominal Aneurysm Repair Using Open Source Image Processing Software.

Eva Knöps¹, Jan van Schaik¹, Koen E A van der Bogt²

¹Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.

Annals of Vascular Surgery

|September 6, 2020

Summary

OsiriX Lite®, a free software, accurately measures abdominal aortic dimensions for endovascular aneurysm repair (EVAR) stent graft sizing. It performs comparably to commercial software in both accuracy and planning time.

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Area of Science:

Vascular Surgery
Medical Imaging Analysis
Health Informatics

Background:

Accurate preoperative sizing of stent grafts using computed tomography angiography (CTA) is crucial for successful abdominal endovascular aneurysm repair (EVAR).
Commercial software for aortic measurements can be costly.
OsiriX Lite® offers a free, open-source alternative for image processing.

Purpose of the Study:

To assess the concurrent validity of OsiriX Lite® for EVAR sizing.
To compare OsiriX Lite® with commercial software (3Mensio Vascular® and Siemens Syngo.via®) in terms of accuracy and time efficiency.

Main Methods:

20 CTA scans from EVAR patients (10 elective, 10 ruptured) were analyzed.
Six observers measured 20 parameters using OsiriX Lite®, 3Mensio Vascular®, or Siemens Syngo.via®.
Interrater agreement was calculated using intraclass correlation coefficients (ICC) and P-values, interpreted with Koo and Li Guidelines. Planning time was also compared.

Main Results:

Good or moderate interrater agreement was achieved for 80% (16/20) of parameters across the three software options.
No significant difference in EVAR planning time was observed between OsiriX Lite® (568 sec), 3Mensio Vascular® (603 sec), and Siemens Syngo.via® (659 sec) (P=0.88).

Conclusions:

OsiriX Lite® demonstrates concurrent validity for preoperative EVAR stent graft sizing.
The free software is a time-effective and accurate option comparable to commercial alternatives.