RT Journal Article
SR Electronic
T1 Separating the wheat from the chaff: region of interest combined with metal artifact reduction for completion angiography following cerebral aneurysm treatment
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 1163
OP 1167
DO 10.1136/neurintsurg-2015-011911
VO 8
IS 11
A1 Duckworth, Edward A M
A1 Nickele, Chris
A1 Schafer, Sebastian
A1 Bauer, Sebastian
A1 Scholz, Bernhard
A1 Elijovich, Lucas
A1 Hoit, Daniel
A1 Doss, Vinodh T
A1 Arthur, Adam S
YR 2016
UL http://jnis.bmj.com/content/8/11/1163.abstract
AB Introduction Following complicated endovascular or microsurgical treatments, assessment of radiographic outcome can be challenging due to device resolution and metallic artifact. Two-dimensional and three-dimensional angiography can reveal information about flow and aneurysm obliteration, but may be limited by beam hardening, overlapping vessels, and image degradation in the region of metallic implants. In this study, we investigated the combination of a collimated volumetric imaging (volume of interest, VOI) protocol followed by metal artifact reduction (MAR) post-processing to evaluate the correct positioning of stents, flow diverters, coils, and clips while limiting the radiation dose to the patient.Methods 9 patients undergoing 10 procedures were included in our study. All patients underwent endovascular or surgical treatment of a cerebral aneurysm involving stents, flow diverting stents, coils, and/or clips followed by either immediate or early postoperative evaluation of our protocol.Results Image datasets corrected for metallic artifacts (VOI-MAR) were judged to be better—a statistically significant finding—than image datasets only corrected for field of view truncation (VOI alone). Qualitatively, images were more interpretable and informative with regards to device position and apposition to the vessel wall for those cases involving a pipeline, and with regards to encroachment on the parent artery and possible residual aneurysm, in all cases.Conclusions VOI acquisition combined with MAR post-processing provides for accurate and informative evaluation of cerebral aneurysm treatment while limiting the radiation dose to patients.