Mathematical Analysis Of DICOM CT Datasets For Fenestrated And Branched Endografts: Can It All Be Automated?

Vikash R Goel¹, Roy K Greenberg¹, Donald P Greenberg.^2
1Cleveland Clinic Foundation, Cleveland, OH;²Cornell University, Ithaca, NY.

OBJECTIVES: To validate the use of a novel mathematical algorithm applied to DICOM CT data to automate the generation of complex endovascular graft planning.

METHODS: We developed an algorithm to create a mathematical model from DICOM CT data which allows for efficient geometric analysis with repeatable results. This algorithm was applied to high resolution (reconstructed <=1mm) DICOM CT datasets of 15 patients with aneurysms involving the visceral arteries. The longitudinal and rotational relationships of the visceral vessels were determined by the algorithm. For comparison purposes, the same measurements were acquired manually using centerline of flow software (TeraRecon) by a blinded investigator. The distance between the renal arteries, and location of the renal origins calculated with each method were then compared.

RESULTS: The results of both the manual and automated methods of calculating inter-renal distance and rotational positions are shown in the graph. The mean inter-renal artery distance differed between the automated and manual methods by a mean of 1.3mm, while the rotational position of the renal origins differed by only 21 minutes on average.

CONCLUSIONS: The ability to express the aorta as a mathematical model holds great promise for eliminating the need for complex measurements to be acquired, such as those necessary for fenestrated or branched grafts, potentially facilitating the dissemination of this technology. Additional attributes include the expression of the 3D aorta in a compact form (on the order of kilobytes) for purposes of data storage, transfer, and other manipulations.