Deep Learning–Based Intraoperative Stent Graft Segmentation on Completion Digital Subtraction Angiography During Endovascular Aneurysm Repair

Kaj O. Kappe, Stefan P.M. Smorenburg, Arjan W.J. Hoksbergen, Jelmer M. Wolterink, Kak Khee Yeung*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)
60 Downloads (Pure)

Abstract

Purpose: Modern endovascular hybrid operating rooms generate large amounts of medical images during a procedure, which are currently mostly assessed by eye. In this paper, we present fully automatic segmentation of the stent graft on the completion digital subtraction angiography during endovascular aneurysm repair, utilizing a deep learning network.

Technique: Completion digital subtraction angiographies (cDSAs) of 47 patients treated for an infrarenal aortic aneurysm using EVAR were collected retrospectively. A two-dimensional convolutional neural network (CNN) with a U-Net architecture was trained for segmentation of the stent graft from the completion angiographies. The cross-validation resulted in an average Dice similarity score of 0.957 ± 0.041 and median of 0.968 (IQR: 0.950 – 0.976). The mean and median of the average surface distance are 1.266 ± 1.506 mm and 0.870 mm (IQR: 0.490 – 1.430), respectively.

Conclusion: We developed a fully automatic stent graft segmentation method based on the completion digital subtraction angiography during EVAR, utilizing a deep learning network. This can provide the platform for the development of intraoperative analytical applications in the endovascular hybrid operating room such as stent graft deployment accuracy, endoleak visualization, and image fusion correction.

Original languageEnglish
Pages (from-to)822-827
Number of pages6
JournalJournal of Endovascular Therapy
Volume30
Issue number6
Early online date9 Jul 2022
DOIs
Publication statusPublished - Dec 2023

Keywords

  • AAA
  • Abdominal aortic aneurysms
  • Artificial Intelligence (AI)
  • Automatic
  • Deep learning
  • Digital subtraction angiography
  • Endovascular aneurysm repair
  • EVAR
  • Intraoperative
  • Segmentation

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