Multidetector CT Angiography of Arterial Inflow and Runoff in the Lower Extremities: A Challenge in Data Acquisition and Evaluation

Daniel T. Boll, Jonathan S. Lewin, Thorsten R. Fleiter, Jeffrey L. Duerk, Elmar M. Merkle

Research output: Contribution to journalArticle

Abstract

Purpose: To show the feasibility of acquiring homogenous 3-dimensional datasets with high temporal and spatial resolution from computed tomographic angiographic (CTA) scans of the lower extremities and to assess automated vessel-tracking techniques for vascular evaluation. Methods: Eighteen men (mean age 67.0 years, range 43-83) with aneurysmal or occlusive vascular diseases underwent contrast-enhanced CTA of the lower limb arteries utilizing a 16-row CT imager. Curved multiplanar reformations were generated by manual selection of vessel centerlines in the infrarenal aorta and the arterial vasculature in the pelvis, thigh, and calf based on volume-rendering techniques. For each vessel, opacification and depiction were quantitatively evaluated. The manually segmented images were compared to datasets processed with automated vessel-tracking strategies by 5 radiologists, who evaluated diagnostic reliability and image quality. A Differential Receiver Operating Characteristic (DROC) analysis was performed. Results: An increase in the temporal and spatial resolution led to acquisition of high quality CTA datasets. Significant homogeneity of the vascular contrast-to-noise ratios was achieved in the pelvic (coefficient of variance 1.5% to 10.1%), thigh (0.1% to 9.4%), and calf (3.3% to 19.2%) vessels. The assessment of vascular delineation revealed full-width-at-half-maximum contrast values of 96.4%, 95.5%, and 111.3% in the pelvis, thigh, and calf, respectively. Observers were not able to distinguish between manual and automated vascular segmentation, as represented by a 0.56 value for the area under the DROC curve. Conclusions: High-resolution CTA lower extremity datasets were acquired successfully, presenting vascular signal intensities of high homogeneity suitable for automated vessel-tracking techniques. Automated 3D visualization tools produced reliable, reproducible, and time-efficient centerline extractions that were comparable to manually defined centerlines.

Original languageEnglish (US)
Pages (from-to)144-151
Number of pages8
JournalJournal of Endovascular Therapy
Volume11
Issue number2
DOIs
StatePublished - Apr 2004
Externally publishedYes

Fingerprint

Blood Vessels
Lower Extremity
Thigh
Pelvis
ROC Curve
Vascular Diseases
Aorta
Noise
Arteries
Computed Tomography Angiography
Datasets

Keywords

  • Computed tomographic angiography
  • Curved multiplanar reformations
  • Lower limb
  • Multidetector CT scanner
  • Peripheral arterial disease
  • Vessel-tracking techniques
  • Volume-rendering techniques

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Multidetector CT Angiography of Arterial Inflow and Runoff in the Lower Extremities : A Challenge in Data Acquisition and Evaluation. / Boll, Daniel T.; Lewin, Jonathan S.; Fleiter, Thorsten R.; Duerk, Jeffrey L.; Merkle, Elmar M.

In: Journal of Endovascular Therapy, Vol. 11, No. 2, 04.2004, p. 144-151.

Research output: Contribution to journalArticle

Boll, Daniel T. ; Lewin, Jonathan S. ; Fleiter, Thorsten R. ; Duerk, Jeffrey L. ; Merkle, Elmar M. / Multidetector CT Angiography of Arterial Inflow and Runoff in the Lower Extremities : A Challenge in Data Acquisition and Evaluation. In: Journal of Endovascular Therapy. 2004 ; Vol. 11, No. 2. pp. 144-151.
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abstract = "Purpose: To show the feasibility of acquiring homogenous 3-dimensional datasets with high temporal and spatial resolution from computed tomographic angiographic (CTA) scans of the lower extremities and to assess automated vessel-tracking techniques for vascular evaluation. Methods: Eighteen men (mean age 67.0 years, range 43-83) with aneurysmal or occlusive vascular diseases underwent contrast-enhanced CTA of the lower limb arteries utilizing a 16-row CT imager. Curved multiplanar reformations were generated by manual selection of vessel centerlines in the infrarenal aorta and the arterial vasculature in the pelvis, thigh, and calf based on volume-rendering techniques. For each vessel, opacification and depiction were quantitatively evaluated. The manually segmented images were compared to datasets processed with automated vessel-tracking strategies by 5 radiologists, who evaluated diagnostic reliability and image quality. A Differential Receiver Operating Characteristic (DROC) analysis was performed. Results: An increase in the temporal and spatial resolution led to acquisition of high quality CTA datasets. Significant homogeneity of the vascular contrast-to-noise ratios was achieved in the pelvic (coefficient of variance 1.5{\%} to 10.1{\%}), thigh (0.1{\%} to 9.4{\%}), and calf (3.3{\%} to 19.2{\%}) vessels. The assessment of vascular delineation revealed full-width-at-half-maximum contrast values of 96.4{\%}, 95.5{\%}, and 111.3{\%} in the pelvis, thigh, and calf, respectively. Observers were not able to distinguish between manual and automated vascular segmentation, as represented by a 0.56 value for the area under the DROC curve. Conclusions: High-resolution CTA lower extremity datasets were acquired successfully, presenting vascular signal intensities of high homogeneity suitable for automated vessel-tracking techniques. Automated 3D visualization tools produced reliable, reproducible, and time-efficient centerline extractions that were comparable to manually defined centerlines.",
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T2 - A Challenge in Data Acquisition and Evaluation

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AU - Lewin, Jonathan S.

AU - Fleiter, Thorsten R.

AU - Duerk, Jeffrey L.

AU - Merkle, Elmar M.

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AB - Purpose: To show the feasibility of acquiring homogenous 3-dimensional datasets with high temporal and spatial resolution from computed tomographic angiographic (CTA) scans of the lower extremities and to assess automated vessel-tracking techniques for vascular evaluation. Methods: Eighteen men (mean age 67.0 years, range 43-83) with aneurysmal or occlusive vascular diseases underwent contrast-enhanced CTA of the lower limb arteries utilizing a 16-row CT imager. Curved multiplanar reformations were generated by manual selection of vessel centerlines in the infrarenal aorta and the arterial vasculature in the pelvis, thigh, and calf based on volume-rendering techniques. For each vessel, opacification and depiction were quantitatively evaluated. The manually segmented images were compared to datasets processed with automated vessel-tracking strategies by 5 radiologists, who evaluated diagnostic reliability and image quality. A Differential Receiver Operating Characteristic (DROC) analysis was performed. Results: An increase in the temporal and spatial resolution led to acquisition of high quality CTA datasets. Significant homogeneity of the vascular contrast-to-noise ratios was achieved in the pelvic (coefficient of variance 1.5% to 10.1%), thigh (0.1% to 9.4%), and calf (3.3% to 19.2%) vessels. The assessment of vascular delineation revealed full-width-at-half-maximum contrast values of 96.4%, 95.5%, and 111.3% in the pelvis, thigh, and calf, respectively. Observers were not able to distinguish between manual and automated vascular segmentation, as represented by a 0.56 value for the area under the DROC curve. Conclusions: High-resolution CTA lower extremity datasets were acquired successfully, presenting vascular signal intensities of high homogeneity suitable for automated vessel-tracking techniques. Automated 3D visualization tools produced reliable, reproducible, and time-efficient centerline extractions that were comparable to manually defined centerlines.

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