Automatic 3D aortic annulus sizing by computed tomography in the planning of transcatheter aortic valve implantation |
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Authors: | Sandro Queirós,Christophe Dubois,Pedro Morais,Tom Adriaenssens,Jaime C. Fonseca,Jo?o L. Vila?a,Jan D hooge |
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Affiliation: | 1. Dept. of Cardiovascular Sciences, KU Leuven, Leuven, Belgium;2. ICVS/3B''s - PT Government Associate Laboratory, Braga, Guimarães, Portugal;3. Algoritmi Center, School of Engineering, University of Minho, Guimarães, Portugal;4. Dept. of Cardiovascular Diseases, University Hospital Leuven, Leuven, Belgium;5. INEGI, Faculty of Engineering, University of Porto, Porto, Portugal;6. DIGARC – Polytechnic Institute of Cávado and Ave, Barcelos, Portugal |
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Abstract: | BackgroundAccurate imaging assessment of aortic annulus (AoA) dimension is paramount to decide on the correct transcatheter heart valve (THV) size for patients undergoing transcatheter aortic valve implantation (TAVI). We evaluated the feasibility and accuracy of a novel automatic framework for multidetector row computed tomography (MDCT)-based TAVI planning.MethodsAmong 122 consecutive patients undergoing TAVI and retrospectively reviewed for this study, 104 patients with preoperative MDCT of sufficient quality were enrolled and analyzed with the proposed software. Fully automatic (FA) and semi-automatic (SA) AoA measurements were compared to manual measurements, with both automated and manual-based interobserver variability (IOV) being assessed. Finally, the effect of these measures on hypothetically selected THV size was evaluated against the implanted size, as well as with respect to manually-derived sizes.ResultsFA analysis was feasible in 92.3% of the cases, increasing to 100% if using the SA approach. Automatically-extracted measurements showed excellent agreement with manually-derived ones, with small biases and narrow limits of agreement, and comparable to the interobserver agreement. The SA approach presented a statistically lower IOV than manual analysis, showing the potential to reduce interobserver sizing disagreements. Moreover, the automated approaches displayed close agreement with the implanted sizes, similar to the ones obtained by the experts.ConclusionThe proposed automatic framework provides an accurate and robust tool for AoA measurements and THV sizing in patients undergoing TAVI. |
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Keywords: | Computed tomography TAVI Aortic valve sizing Fully automatic analysis Semi-automatic analysis |
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