Automatic aortic root landmark detection in CTA images for preprocedural planning of transcatheter aortic valve implantation.
Transcatheter aortic valve implantation is currently a well-established minimal invasive treatment option for patients with severe aortic valve stenosis. CT Angiography is used for the pre-operative planning and sizing of the prosthesis. To reduce the inconsistency in sizing due to interobserver variability, we introduce and evaluate an automatic aortic root landmarks detection method to determine the sizing parameters. The proposed algorithm detects the sinotubular junction, two coronary ostia, and three valvular hinge points on a segmented aortic root surface. Using these aortic root landmarks, the automated method determines annulus radius, annulus orientation, and distance from annulus plane to right and left coronary ostia. Validation is performed by the comparison with manual measurements of two observers for 40 CTA image datasets. Detection of landmarks showed high accuracy where the mean distance between the automatically detected and reference landmarks was 2.81 ± 2.08 mm, comparable to the interobserver variation of 2.67 ± 2.52 mm. The mean annulus to coronary ostium distance was 16.9 ± 3.3 and 17.1 ± 3.3 mm for the automated and the reference manual measurements, respectively, with a mean paired difference of 1.89 ± 1.71 mm and interobserver mean paired difference of 1.38 ± 1.52 mm. Automated detection of aortic root landmarks enables automated sizing with good agreement with manual measurements, which suggests applicability of the presented method in current clinical practice.
Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. mustafa.elattar@gmail.com.
Mustafa
http://orcid.org/0000-0001-7936-3522
M
Elattar
Heartcenter, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Esther
E
Wiegerinck
Heartcenter, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Floortje
F
van Kesteren
Biomedical Engineering, Polytech Lyon, Université Claude Bernard Lyon, Villeurbanne, France.
Lucile
L
Dubois
Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Nils
N
Planken
Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Ed
E
Vanbavel
Heartcenter, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Jan
J
Baan
Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Henk
H
Marquering
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059925:Anatomic Landmarks; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D001027:Aortography / Q000379:methods*; D001331:Automation; D006328:Cardiac Catheterization / Q000295:instrumentation; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed
Aortic root; CTA; Detection; Landmarks; Segmentation; TAVI