Key result
3D aortic geometry mapping shows markedly higher reproducibility over manual assessment for aortic growth rates.
Why the study?
Manual assessment of aortic dimensions is subjective, poorly reproducible, and time-consuming, limiting tracking of aortic growth in clinical practice.
Does aortic geometry mapping via 3D image registration improve the accuracy and reproducibility of aortic diameter and growth rate measurements compared to manual assessment in patients with thoracic aortic disease?
Observational (n=45)
Does aortic geometry mapping via 3D image registration improve the accuracy and reproducibility of aortic diameter and growth rate measurements compared to manual assessment in patients with thoracic aortic disease?
Answers are grounded in this paper and cite their sources.
Aortic geometry mapping via 3D image registration of serial MR angiographies provides highly reproducible measurements of aortic diameter and growth rate, outperforming standard manual assessment.
BACKGROUND: The measurement of aortic dimensions and their evolution are key in the management of patients with aortic diseases. Manual assessment, the current guideline-recommended method and clinical standard, is subjective, poorly reproducible, and time-consuming, limiting the capacity to track aortic growth in everyday practice. Aortic geometry mapping (AGM) via image registration of serial computed tomography angiograms outperforms manual assessment, providing accurate and reproducible 3D maps of aortic diameter and growth rate. This observational study aimed to evaluate the accuracy and reproducibility of AGM on non-gated contrast-enhanced (CE-) and cardiac- and respiratory-gated (GN-) magnetic resonance angiographies (MRA). METHODS: Patients with thoracic aortic disease followed with serial CE-MRA (n = 30) or GN-MRA (n = 15) acquired at least 1 year apart were retrospectively and consecutively identified. Two independent observers measured aortic diameters and growth rates (GR) manually at several thoracic aorta reference levels and with AGM. Agreement between manual and AGM measurements and their inter-observer reproducibility were compared. Reproducibility for aortic diameter and GR maps assessed with AGM was obtained. RESULTS: Mean follow-up was 3.8 ± 2.3 years for CE- and 2.7 ± 1.6 years for GN-MRA. AGM was feasible in the 93% of CE-MRA pairs and in the 100% of GN-MRA pairs. Manual and AGM diameters showed excellent agreement and inter-observer reproducibility (ICC>0.9) at all anatomical levels. Agreement between manual and AGM GR was more limited, both in the aortic root by GN-MRA (ICC=0.47) and in the thoracic aorta, where higher accuracy was obtained with GN- than with CE-MRA (ICC=0.55 vs 0.43). The inter-observer reproducibility of GR by AGM was superior compared to manual assessment, both with CE- (thoracic: ICC= 0.91 vs 0.51) and GN-MRA (root: ICC=0.84 vs 0.52; thoracic: ICC=0.93 vs 0.60). AGM-based 3D aortic size and growth maps were highly reproducible (median ICC >0.9 for diameters and >0.80 for GR). CONCLUSION: Mapping aortic diameter and growth on MRA via 3D image registration is feasible, accurate and outperforms the current manual clinical standard. This technique could broaden the possibilities of clinical and research evaluation of patients with aortic thoracic diseases.
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Dux‐Santoy et al. (2024) conducted an observational in Thoracic aortic disease (n=45). Aortic geometry mapping (AGM) via 3D image registration vs. Manual assessment was evaluated on Accuracy and inter-observer reproducibility of aortic diameters and growth rates. Aortic geometry mapping via 3D image registration outperformed manual assessment in inter-observer reproducibility for thoracic aortic growth rates using CE-MRA (ICC 0.91 vs 0.51).
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