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Automatic depth measurements of lower-extremity arteries and carotid artery tortuosity, curvature and torsion measurements

Klaassen, Jurre (2020) Automatic depth measurements of lower-extremity arteries and carotid artery tortuosity, curvature and torsion measurements.

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Embargo date:15 April 2022
Abstract:Aims: To develop a technique that can automatically measure the depth of lower-extremity arteries and to address the clinical implication of carotid artery (CA) geometry expressed in tortuosity index (TI), curvature and torsion. Method and Materials: Manual depth measurements were performed by three independent observers in 5 predefined measurement directions at 4 anatomical locations in 35 unique computed tomography angiography (CTA) studies. Measurement reproducibility was assessed with intraclass correlation coefficient (ICC) and Bland-Altman plots. Next, automatic depth measurement technique was developed in MATLAB to measure lower-extremity arterial depth and validated using phantom study and same 35 CTA studies. Measurement agreement of manual and automatic performed arterial depth measurements at the superficial femoral artery (SFA) was assessed using ICC and Bland-Altman plots. To address clinical implication of CA geometry, two independent observers performed 175 TI measurements of the CA in 140 unique CTA studies using 3Mensio software. Moreover, MATLAB was used to calculate curvature and torsion using coordinates of exported 3Mensio 1mm interpolated CA central luminal line (CLL). Intra- and interobserver agreement was assessed using ICC and visualized using Bland-Altman plots. Moreover, correlation of TI, curvature and torsion was assessed when comparing intra-patient ipsi- and contralateral CA with present extracranial carotid artery aneurysm (ECAA) and when comparing CA of ECAA patients with control patients. Finally, Pearson correlation coefficient was calculated to test correlation between measured TI, curvature and torsion. Results: Assessed intraobserver agreement of manual performed depth measurements showed excellent reliability and agreement in SFA. Validation of developed automatic depth measurement technique showed that only the set requirement of maximum measurement deviation of 3mm was achieved. Moreover, assessed manual and automatic measurement agreement at the SFA showed excellent reliability and agreement. Furthermore, assessment of intra-and interobserver agreement of TI measurements showed excellent reliability and agreement all cases, indicating that TI measurements are reproducible. In addition, no significant difference was found between ipsi- and contralateral CA in ECAA patients, while this difference was significant between the ECAA and the control group. Moreover, strong and positive correlation was found between true length and sharp bends of the carotid arteries. Conclusion: The arterial depth of the lower extremities can be measured in any case at the level of the SFA using the developed automatic depth measurement technique. Furthermore, geometry of the CA in terms of tortuosity index, curvature and torsion, seems to be comparable within patients with a carotid aneurysm, but in comparison with control patients seems strikingly different. Additionally, a strong and positive correlation was found between true length and sharp bends of the carotid arteries.
Item Type:Essay (Master)
Clients:
UMC Utrecht, Utrecht, Nederland
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Technical Medicine MSc (60033)
Link to this item:http://purl.utwente.nl/essays/80979
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