title: Increasing the feasibility of minimally invasive procedures in type A aortic dissections: a framework for segmentation and quantification.
abstract: OBJECTIVE
  Our goal is to provide precise measurements of the aortic dimensions in case of dissection pathologies. Quantification of surface lengths and aortic radii/diameters together with the visualization of the dissection membrane represents crucial prerequisites for enabling minimally invasive treatment of type A dissections, which always also imply the ascending aorta.
  
  
  METHODS
  We seek a measure invariant to luminance and contrast for aortic outer wall segmentation. Therefore, we propose a 2D graph-based approach using phase congruency combined with additional features. Phase congruency is extended to 3D by designing a novel conic directional filter and adding a lowpass component to the 3D Log-Gabor filterbank for extracting the fine dissection membrane, which separates the true lumen from the false one within the aorta.
  
  
  RESULTS
  The result of the outer wall segmentation is compared with manually annotated axial slices belonging to 11 CTA datasets. Quantitative assessment of our novel 2D/3D membrane extraction algorithms has been obtained for 10 datasets and reveals subvoxel accuracy in all cases. Aortic inner and outer surface lengths, determined within 2 cadaveric CT datasets, are validated against manual measurements performed by a vascular surgeon on excised aortas of the body donors.
  
  
  CONCLUSIONS
  This contribution proposes a complete pipeline for segmentation and quantification of aortic dissections. Validation against ground truth of the 3D contour lengths quantification represents a significant step toward custom-designed stent-grafts.
authors: Intelligent Systems, Faculty of Engineering, University of Duisburg-Essen, 47057, Duisburg, Germany. adrian.morariu@uni-due.de.
authors: Cosmin Adrian
authors: CA
authors: Morariu
authors: Intelligent Systems, Faculty of Engineering, University of Duisburg-Essen, 47057, Duisburg, Germany.
authors: Tobias
authors: T
authors: Terheiden
authors: Department of Thoracic and Cardiovascular Surgery, University Clinic Essen, Essen, Germany.
authors: Daniel Sebastian
authors: DS
authors: Dohle
authors: Department of Thoracic and Cardiovascular Surgery, University Clinic Essen, Essen, Germany.
authors: Konstantinos
authors: K
authors: Tsagakis
authors: Intelligent Systems, Faculty of Engineering, University of Duisburg-Essen, 47057, Duisburg, Germany.
authors: Josef
authors: J
authors: Pauli
mesh_terms: D000465:Algorithms; D000784:Aortic Dissection / Q000175:diagnosis / Q000601:surgery*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D057510:Endovascular Procedures; D005240:Feasibility Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D011474:Prosthesis Design; D015203:Reproducibility of Results; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: 2D/3D phase congruency; Aortic dissection; Endovascular repair; Optimal path; Patient-specific stent-graft