Patient-specific three-dimensional aortic arch modeling for automatic measurements: clinical validation in aortic coarctation

Benedetta Leonardi, Giuseppe D'Avenio, Dime Vitanovski, Mauro Grigioni, Marco A. Perrone, Francesco Romeo, Aurelio Secinaro, Allen D. Everett, Giacomo Pongiglione

Research output: Contribution to journalArticle

Abstract

AIM: A validated algorithm for automatic aortic arch measurements in aortic coarctation (CoA) patients could standardize procedures for clinical planning. METHODS: The model-based assessment of the aortic arch anatomy consisted of three steps: first, machine-learning-based algorithms were trained on 212 three-dimensional magnetic resonance (MR) data to automatically allocate the aortic arch position in patients and segment the aortic arch; second, for each CoA patient (N = 33), the min/max aortic arch diameters were measured using the proposed software, manually and automatically, from noncontrast-enhanced three-dimensional steady-state free precession MRI sequence at five selected sites and compared ('internal comparison' referring to the same environment); third, moreover, the same min/max aortic arch diameters were compared, obtaining them independently, manually from common MR management software (MR Viewforum) and automatically from the model (external comparison). The measured sites were: aortic sinus, sino-tubular junction, mid-ascending aorta, transverse arch and thoracoabdominal aorta at the level of the diaphragm. RESULTS: Manual and software-assisted measurements showed a good agreement: the difference between diameter measurements was not statistically significant (at α = 0.05), with only one exception, for both internal and external comparison. A high coefficient of correlation was attained for both maximum and minimum diameters in each site (for internal comparison, R > 0.73 for every site, with P < 2 × 10). Notably, in tricuspid aortic valve patients external comparison showed no statistically significant difference at any measurement sites. CONCLUSION: The automatically derived aortic arch model, starting from three-dimensional MR images, could be a support to take the measurements in CoA patients and to quickly provide a patient-specific model of aortic arch anomalies.

Original languageEnglish (US)
Pages (from-to)517-528
Number of pages12
JournalJournal of cardiovascular medicine (Hagerstown, Md.)
Volume21
Issue number7
DOIs
StatePublished - Jul 1 2020

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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