title: Automated CTA based measurements for planning support of minimally invasive aortic valve replacement surgery.
abstract: Minimally invasive aortic valve replacement (mini-AVR) procedures are a valuable alternative to conventional open heart surgery. Currently, planning of mini-AVR consists of selection of the intercostal space closest to the sinotubular junction on preoperative computer tomography images. We developed an automated algorithm detecting the sinotubular junction (STJ) and intercostal spaces for finding the optimal incision location. The accuracy of the STJ detection was assessed by comparison with manual delineation by measuring the Euclidean distance between the manually and automatically detected points. In all 20 patients, the intercostal spaces were accurately detected. The median distance between automated and manually detected STJ locations was 1.4 [IQR= 0.91-4.7] mm compared to the interobserver variation of 1.0 [IQR= 0.54-1.3] mm. For 60% of patients, the fourth intercostal space was the closest to the STJ. The proposed algorithm is the first automated approach for detecting optimal incision location and has the potential to be implemented in clinical practice for planning of various mini-AVR procedures.
authors.affiliation: Department of Biomedical Engineering and Physics, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: mustafa.elattar@gmail.com.
authors.forename: Mustafa A
authors.initials: MA
authors.lastname: Elattar
authors.affiliation: Departments of Radiology, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Department of Heart Center, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Floortje
authors.initials: F
authors.lastname: van Kesteren
authors.affiliation: Department of Heart Center, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Esther M
authors.initials: EM
authors.lastname: Wiegerinck
authors.affiliation: Department of Biomedical Engineering and Physics, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Ed
authors.initials: E
authors.lastname: Vanbavel
authors.affiliation: Department of Heart Center, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Baan
authors.affiliation: Department of Heart Center, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Cocchieri
authors.affiliation: Department of Heart Center, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Bas
authors.initials: B
authors.lastname: de Mol
authors.affiliation: Departments of Radiology, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Nils R
authors.initials: NR
authors.lastname: Planken
authors.affiliation: Department of Biomedical Engineering and Physics, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Departments of Radiology, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Henk A
authors.initials: HA
authors.lastname: Marquering
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000601:surgery*; D001331:Automation; D000072226:Computed Tomography Angiography / Q000379:methods*; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures
keywords: CT angiograph; Intercostal spaces; Mini-AVR; Segmentation; Sinotubular junction