Computer Aided Intracranial Aneurysm Treatment Based on 2D/3D Mapping, Virtual Deployment and Online Distal Marker...

Area of Science:

• Medical Imaging
• Computational Fluid Dynamics
• Neurosurgery

Background:

• Intracranial aneurysms pose significant treatment challenges.
• Flow diverter (FD) placement requires precise pre-operative planning and intra-operative guidance.
• Current methods may lack seamless integration of pre-operative simulations with real-time surgical feedback.

Purpose of the Study:

• To develop and validate a computational tool for peri-interventional intracranial aneurysm treatment guidance.
• To map pre-operative simulation data onto real-time X-ray imaging for enhanced surgical decision-making.

Main Methods:

• Pre-operative simulation of multiple FD devices on 3D vessel meshes to select optimal parameters.
• Real-time alignment and mapping of 3D simulation data to 2D X-ray feeds.
• Automatic detection of FD marker locations to estimate device position in the 3D model.

Main Results:

• Validation using retrospective biplane images from four patients (5 3D-DSA datasets).
• Average F1-score of 0.67 for distal FD marker detection in 412 X-ray scans.
• Average difference of 0.832 mm between simulated and deployed FD positions after 3D-DSA and 2D-X-ray alignment.

Conclusions:

• The proposed method effectively merges pre-operative simulation information with intra-operative visualization.
• This tool supports flow diverter deployment by providing real-time guidance to interventionists.
• Aids in making more accurate and less risky treatment decisions for intracranial aneurysms.