Application of Synthetic Time-Of-Flight Magnetic Resonance Angiography-Computed Tomography Fusion Imaging in Preoperative Planning for Aneurysm Clipping Surgery: A Comparative Study with Three-Dimensional Computed Tomography Angiography.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Author(s): Hou X;Hou X; Wu T; Wu T; Li D; Li D; Xu R; Xu R
  • Source:
    World neurosurgery [World Neurosurg] 2024 Oct; Vol. 190, pp. e302-e309. Date of Electronic Publication: 2024 Jul 19.
  • Publication Type:
    Journal Article; Comparative Study
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: United States NLM ID: 101528275 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-8769 (Electronic) Linking ISSN: 18788750 NLM ISO Abbreviation: World Neurosurg Subsets: MEDLINE
    • Publication Information:
      Original Publication: New York : Elsevier
    • Subject Terms:
    • Abstract:
      Objective: Some patients with intracranial aneurysms (IAs) cannot undergo three-dimensional computed tomography angiography (3D-CTA) or digital subtraction angiography due to contraindications to contrast agents or radiation. Time-of-flight magnetic resonance angiography (TOF-MRA) offers a contrast-free alternative but lacks cranial bone detail critical for surgical planning. This study evaluates the feasibility of using 3D Slicer to fuse TOF-MRA with thin-section CT images to generate synthetic images resembling CTA for surgical clipping planning.
      Methods: This prospective study included 22 patients with unruptured IAs and 8 with ruptured IAs undergoing aneurysm clipping surgery (≥3 mm). TOF-MRA and CT/3D-CTA scans were fused using 3D Slicer. Neuroradiologists and neurosurgeons independently assessed 3D-CTA and synthetic TOF-MRA-CT images for aneurysm detection rates, morphology, and dimensions. Evaluation metrics included dice similarity coefficient and 95% Hausdorff distance.
      Results: Evaluation of aneurysm detection rates, morphology, and dimensions showed no significant differences between synthetic TOF-MRA-CT fusion images and 3D-CTA (all P > 0.05). Neuroradiologist assessments revealed strong concordance in aneurysm morphology between synthetic TOF-MRA-CT fusion images and 3D-CTA (κ = 0.867, P < 0.001). The dice similarity coefficient (0.937 ± 0.012) and Hausdorff distance (4.54 ± 0.26) indicated a high degree of image overlap between synthetic TOF-MRA-CT fusion images and 3D-CTA. Surgeons rated the consistency of aneurysm morphology between synthetic TOF-MRA-CT fusion images and intraoperative findings as strongly concordant (κ = 0.873, P < 0.001).
      Conclusions: Synthetic TOF-MRA-CT fusion images closely match 3D-CTA for ≥3 mm aneurysms, demonstrating comparable diagnostic and surgical clipping planning effectiveness. They represent a promising alternative for personalized preoperative planning, particularly when contrast agents are contraindicated.
      (Copyright © 2024 Elsevier Inc. All rights reserved.)
    • Contributed Indexing:
      Keywords: 3D-CTA; Intracranial aneurysms; Multimodal fusion; Synthetic; TOF-MRA-CT
    • Publication Date:
      Date Created: 20240721 Date Completed: 20241019 Latest Revision: 20241019
    • Publication Date:
      20241020
    • Accession Number:
      10.1016/j.wneu.2024.07.119
    • Accession Number:
      39033806