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Enhancing cerebral vasculature analysis with pathlength-corrected 2D angiographic parametric imaging: A feasibility
Allison Shields1,2, Kyle Williams1,2, Mohammad Mahdi Shiraz Bhurwani3
1Medical Physics Program, University at Buffalo, Buffalo, New York, USA.
Medical Physics
|October 21, 2023
Summary
Pathlength correction standardizes 2D angiographic parametric imaging (API) biomarkers, improving hemodynamic analysis accuracy. This method corrects for projection variability, enhancing diagnostic value in 2D digital subtraction angiography (DSA).
Area of Science:
- Medical Imaging
- Biomedical Engineering
- Computational Fluid Dynamics
Background:
- 2D angiographic parametric imaging (API) quantifies contrast flow but is limited by projection artifacts in 2D digital subtraction angiography (DSA).
- Limitations include vessel overlap, foreshortening, and depth-integration of contrast motion, hindering accurate hemodynamic analysis.
- Conventional 2D-API is sensitive to projection angle, impacting biomarker reliability.
Purpose of the Study:
- To investigate a pathlength-correction metric to overcome 2D-API limitations.
- To study the conversion of 3D contrast flow to projected contrast flow using a simulated framework.
- To remove acquisition variability and improve the accuracy of 2D-API.
Main Methods:
- Applied a pathlength-correction framework to in-silico angiograms from patient-specific aneurysm geometries.
- Generated biplane projections from 3D contrast distributions and used ray tracing to create a pathlength-correction map.
- Compared voxel-wise 3D API with pixel-wise 2D API (with and without pathlength correction) and calculated percentage differences (PD) in the aneurysm region of interest (ROI).
Main Results:
- Pathlength correction accurately represented mass conservation and reflected stagnation/recirculation regions.
- Improved agreement between biplane maps: max PD reduced from 47.7% to 3.3% without and with correction, respectively.
- Max PD with 3D counterparts reduced to 5.8% after correction, especially in large aneurysms; temporal parameters were unaffected.
Conclusions:
- Intensity-based 2D-API parameters are highly projection-dependent and should be avoided for hemodynamic analysis without correction.
- The proposed pathlength-correction metric standardizes 2D API biomarkers, making them independent of projection orientation.
- Integrating pathlength correction can enhance the diagnostic value and accuracy of 2D-DSA for cerebral vasculature procedures.
