Abstract
Computer-aided diagnosis (CAD) systems have been used in several areas of medicine for the last number of years. A typical CAD system interprets medical images and provides guidance for the clinician. The concept of CAD in the assessment of abdominal aortic aneurysm (AAA) has been around for several years, however, the technique is gaining momentum as of late. Computer modeling of AAAs is becoming more prevalent with several novel approaches of CAD reported over the past number of years. CAD is possible through computer-aided detection (CADe) and computer-aided quantification (CADq) techniques that work together to return usable quantities aimed at helping identify AAAs that may be at risk of rupture. This chapter examines some recent developments within the area of CAD for AAAs, in particular the use of peak wall stress, and also asymmetry and the finite element analysis rupture index. All three tools provide additional data to the clinician through the CAD system and help complement the use of maximum diameter in identifying high-risk AAAs.
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- 1.
ILT consists of a fibrin structure incorporated with blood cells, platelets, blood proteins and cellular debris, and are found in most AAAs.
References
Bluestein, D., Dumont, K., De Beule, M., Ricotta, J., Impellizzeri, P., Verhegghe, B., Verdonck, P.: Intraluminal thrombus and risk of rupture in patient-specific abdominal aortic —FSI modeling. Comput. Methods Biomech Biomed Eng. 12, 73–81 (2009)
Breeuwer, M., de Putter, S., Kose, U., Speelman, L., Visser, K., Gerritsen, F., Hoogeveen, R., Krams, R., van den Bosch, H., Buth, J., Gunther, T., Wolters, B., van Dam, E., van de Vosse, F.: Towards patient-specific risk assessment of abdominal aortic aneurysm. Med. Biol. Eng. Comput. 46, 1085–1095 (2008)
Conway, K.P, Byrne, J., Townsend, M., Lane, IF.: Prognosis of patients turned down for conventional abdominal aortic aneurysm repair in the endovascular and sonographic era: Szilagyi revisted? J. Vasc. Surg. 33, 752–757 (2001)
Cronenwett, J.L., Murphy, T.F., Zelenock, G.B., Whitehouse, Jr W.M., Lindenauer S.M., Graham, L.M., Quint, L.E., Silver T.M., Stanley, J.C.: Actuarial analysis of variables associated with rupture of small abdominal aortic aneurysms. Surgery 98, 472–483 (1985)
Darling, R.C., Messina, C.R., Brewster D.C., Ottinger L.W.: Autopsy study of unoperated abdominal aortic aneurysms. The case for early resection. Circulation 56, 161–164 (1977)
Di Martino, E.S., Bohra, A., Vande Geest, J.P., Gupta, N., Makaroun M.S., Vorp, D.A.: Biomechanical properties of ruptured versus electively repaired abdominal aortic aneurysm wall tissue. J. Vasc. Surg. 43, 570–576 (2006)
Doyle, B.J., Callanan, A., McGloughlin, T.M.: A comparison of modelling techniques for computing wall stress in abdominal aortic aneurysms. Biomed. Eng. Online 6, 38 (2007)
Doyle, B.J., Morris, L.G., Callanan, A., Kelly, P., Vorp, D.A., McGloughlin, T.M.: 3D reconstruction and manufacture of real abdominal aortic aneurysms: From CT scan to silicone model. J. Biomech. Eng. 130, 034501 (2008)
Doyle, B.J., Callanan, A., Burke, P.E., Grace, P.A., Walsh, M.T., Vorp, D.A., McGloughlin, T.M.: Vessel asymmetry as an additional tool in the assessment of abdominal aortic aneurysms. J. Vasc. Surg. 49, 443–454 (2009)
Doyle, B.J., Callanan, A., Walsh M.T., Grace P.A., McGloughlin, T.M.: A finite element analysis rupture index (FEARI) as an additional tool for abdominal aortic aneurysm rupture prediction. Vasc. Dis. Prev. 6, 114–121 (2009)
Doyle, B.J., Grace, P.A., Kavanagh, E.G., Burke, P.E., Wallis, F., Walsh, M.T., McGloughlin, T.M.: Improved assessment and treatment of abdominal aortic aneurysms: The use of 3D reconstructions as a surgical guidance tool in endovascular repair. Ir. J. Med. Sci. 178, 321–328 (2009)
Doyle, B.J., Corbett, T.J., Callanan, A., Walsh, M.T., Vorp, D.A., McGloughlin, T.M.: An experimental and numerical comparison of the rupture locations of an abdominal aortic aneurysm. J. Endovasc. Ther. 16, 322–335 (2009)
Doyle, B.J., Coyle, P., Kavanagh, E.G., Grace, P.A., McGloughlin, T.M.: A finite element analysis rupture index (FEARI) assessment of electively repaired and symptomatic/ruptured abdominal aortic aneurysms. IFMBE Proc. 31, 883–886 (2010)
Doyle, B.J., Cloonan, A.J., Walsh, M.T., Vorp, D.A., McGloughlin, T.M.: Identification of rupture locations in patient-specific abdominal aortic aneurysms using experimental and computational techniques. J. Biomech. 43, 1408–1416 (2010)
Elger, D.F., Blackletter, D.M., Budwig, R.S., Johansen, K.H.: The influence of shape on the stresses in model abdominal aortic aneurysms. J. Biomech. Eng. 118, 326–332 (1996)
Ernst, C.B.: Abdominal aortic aneurysm. N. Eng. J. Med. 328, 1167–1172 (1993)
Fenton, J.J., Taplin, S.H., Carney, P.A., Abraham, L., Sickles, E.A., D’Orsi, C., Berns, E.A., Cutter, G., Hendrick, E., Barlow, W.E., Elmore, J.G.: Influence of computer-aided detection on performance of screening mammography. N. Eng. J. Med. 356, 1399–1409 (2007)
Fillinger, M.F., Raghavan, M.L., Marra, S.P., Cronenwett, J.L., Kennedy F.E.: In vivo analysis of mechanical wall stress and abdominal aortic aneurysm rupture risk. J. Vasc. Surg. 36, 589–597 (2002)
Fillinger, M.F., Marra, S.P., Raghavan, M.L., Kennedy, F.E.: Prediction of rupture risk in abdominal aortic aneurysm during observation: wall stress versus diameter. J. Vasc. Surg. 37, 724–732 (2003)
Gasser, T.C., Auer, M., Labruto, F., Swedenborg, J., Roy, J.: Biomechanical rupture risk assessment of abdominal aortic aneurysms: model complexity versus predictability of finite element simulations. Eur. J. Vasc. Endovasc. Surg. (2010). doi:10.1016/j.ejvs.2010.04.003
Giannoglu, G., Giannakoulas, G., Soulis, J., Chatzizisis, Y., Perdikides, T., Melas, N., Parcharidis, G., Louridas, G.: Predicting the risk of rupture of abdominal aortic aneurysms by utilizing various geometrical parameters: revisiting the diameter criterion. Angiology 57, 487–494 (2006)
Glimaker, H., Holmberg, L., Elvin, A., Nybacka, O., Almgren. B., Bjorck, C.G., Eriksson, I.: Natural history of patients with abdominal aortic aneurysm. Eur. J. Vasc. Surg. 5, 125–130 (1991)
Hirose, Y., Takamiya, M.: Growth curve of ruptured aortic aneurysm. J. Cardiovasc. Surg. 39, 9–13 (1998)
Inzoli, F., Boschetti, F., Zappa, M., Longo, T., Fumero, R.: Biomechanical factors in abdominal aortic aneurysm rupture. Eur. J. Vasc. Surg. 7, 667–674 (1993)
Kleinstreuer, C., Li, Z.: Analysis and computer program for rupture risk prediction of abdominal aortic aneurysms. Biomed. Eng. Online 5, 19 (2006)
Lederle, F.A., Johnson, G.R., Wilson, S.E., Ballard, D.J., Jordan Jr ,W.D., Blebea, J., Littooy, F.N., Freischlag, J.A., Bandyk, D., Rapp, J.H., Salam, A.A.: Rupture rate of large abdominal aortic aneurysms in patients refusing or unfit for elective repair. JAMA 287, 2968–2972 (2002)
Leung, J.H., Wright, A.R., Cheshire, N., Crane, J., Thom, S.A., Hughes, A.D., Xu Y Fluid structure interaction of patient specific abdominal aortic aneurysms: a comparison with solid stress models. Biomed. Eng. Online 5, 33 (2006)
Li, Z.Y., U-King-Im, J., Tang, T.Y., Soh, E., See, T.C., Gillard, J.H.: Impact of calcification and intraluminal thrombus on the computed wall stresses of abdominal aortic aneurysm. J. Vasc. Surg. 47, 928–935 (2008)
Lorensen, W.E., Cline, H.E.: Marching cubes: a high resolution 3D surface construction algorithm. Comp. Graphics 21, 163–169 (1987)
Maier, A., Gee, M.W., Reeps, C., Pongratz, J., Eckstein, H.H., Wall, W.A.: A comparison of diameter, wall stress, and rupture potential index for abdominal aortic aneurysm rupture risk prediction. Ann. Biomed. Eng. 38, 3124–3134 (2010)
Maier, A., Gee, M.W., Reeps, C., Eckstein, H.H., Wall, W.A.: Impact of calcifications on patient-specific wall stress analysis of abdominal aortic aneurysms. Biomech. Model. Mechanobiol. 9, 511–521 (2010)
Martufi, G., DiMartino, E.S., Amon, C.H., Muluk, S.C., Finol, E.A.: Three-dimensional geometrical characterization of abdominal aortic aneurysms: image-based wall thickness distribution. J. Biomech. Eng. 131, 061015 (2009)
McGloughlin, T.M., Doyle, B.J.: New approaches to abdominal aortic aneurysm rupture risk assessment: engineering insights with clinical gain. Arterioscler. Thromb. Vasc. Biol. 30, 1687–1694 (2010)
Meyer, C.A., Guivier-Curien, C., Moore, J.E.: Trans-thrombus blood pressure effects in abdominal aortic aneurysms. J. Biomech. Eng. 132, 071005 (2010)
Moore, J.A., Steinman, D.A., Ethier, C.R.: Computational blood flow modeling: errors associated with reconstructing finite element models from magnetic resonance images. J. Biomech. 31, 179–184 (1998)
Morris, L., Delassus, P., Callanan, A., Walsh, M., Wallis, F., Grace, P., McGloughlin, T.: 3D numerical simulation of blood flow through models of the human aorta. J. Biomech. Eng. 127, 767–775 (2005)
Mower, W.R., Baraff, L.J., Sneyd, J.: Stress distributions in vascular aneurysms: factors affecting risk of aneurysm rupture. J. Surg. Res. 55, 155–161 (1993)
National Health Service. National Screening Program for Abdominal Aortic Aneurysm [online] available: http://aaa.screening.nhs.uk (2009). Accessed 9 Feb 2009
Neal, M.L., Kerckhoffs, R.: Current progress in patient-specific modeling. Brief Bioinform. 11, 111–126 (2009)
Nicholls, S.C., Gardner, J.B., Meissner, M.H., Johansen, H.K: Rupture in small abdominal aortic aneurysms. J. Vasc. Surg. 28, 884–888 (1998)
Raghavan, M.L., Vorp, D.A.: Toward a biomechanical tool to evaluate rupture potential of abdominal aortic aneurysm: identification of a finite strain constitutive model and evaluation of its applicability. J. Vasc. Surg. 33, 475–482 (2000)
Raghavan, M.L., Webster, M.W., Vorp, D.A.: Ex vivo biomechanical behaviour of abdominal aortic aneurysm: assessment using a new mathematical model. Ann. Biomed. Eng. 24, 573–582 (1996)
Raghavan, M.L., Vorp, D.A., Federle, M.P., Makaroun, M.S., Webster, M.W.: Wall stress distribution on three-dimensionally reconstructed models of human abdominal aortic aneurysm. J. Vasc. Surg. 31, 760–769 (2000)
Raghavan, M.L., Kratzberg, J., de Tolosa, E.M.C., Hanaoka, M.M., Walter, P., da Silva, E.S.: Regional distribution of wall thickness and failure properties of human abdominal aortic aneurysm. J. Biomech. 39, 3010–3016 (2006)
Sacks, M.S, Vorp, D.A, Raghavan, M.L., Federle, M.P, Webster, M.W.: In vivo three-dimensional surface geometry of abdominal aortic aneurysms. Ann. Biomed. Eng. 27, 469–479 (1999)
Sayers, R.D.: Aortic aneurysms, inflammatory pathways and nitric oxide. Ann. Royal Col. Surg. Eng. 84, 239–246 (2002)
Schurink, G.W.H., van Baalen, J.M., Visser, M.J.T., van Bockel, J.H.: Thrombus within an aortic aneurysm does not reduce pressure on the aneurysmal wall. J. Vasc. Surg. 31, 501–506 (2000)
Scotti, C.M., Shkolnik, A.D., Muluk, S.C., Finol, E.: Fluid-structure interaction in abdominal aortic aneurysms: effect of asymmetry and wall thickness. Biomed. Eng. Online 4, 64 (2005)
Speelman, L., Bohra, A, Bosboom, E.M.H., Schurink, G.W.H., van de Vosse, F.N., Makaroun, M.S., Vorp, D.A.: Effects of wall calcifications in patient-specific wall stress analyses of abdominal aortic aneurysms. J. Biomech. Eng. 129, 1–5 (2007)
Stenbaek, J., Kalin, B., Swedenborg, J.: Growth of thrombus may be a better predictor of rupture than diameter in patients with abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 20, 466–469 (2000)
Stringfellow, M.M., Lawrence, P.F., Stringfellow, R.G.: The influence of aorta geometry upon stress in the aneurysm wall. J. Surg. Res. 42, 425–433 (1987)
Thubrikar, M.J., Labrosse, M., Robicsek, F., Al-Soudi, J., Fowler, B.: Mechanical properties of abdominal aortic aneurysm wall. J. Med. Eng. Tech. 25:133–142 (2001)
Thubrikar M.J, Al-Soudi, J., Robicsek, F.: Wall stress studies of abdominal aortic aneurysm in a clinical model. Ann. Vasc. Surg. 15, 355–366 (2001)
Truijers M., Pol, J.A., SchultzeKool, L.J., van Sterkenburg, S.M., Fillinger, M.F., Blankensteijn, J.D.: Wall stress analysis in small asymptomatic, symptomatic and ruptured abdominal aortic aneurysms. Eur. J. Vasc. Endovasc. Surg. 33, 401–407 (2007)
United States Preventative Services Task Force. Screening for abdominal aortic aneurysm: recommendation statement. Ann. Int. Med. 142, 198–202 (2005)
Vallabhaneni, S.R., Gilling-Smith, G.L., Brennan, J.A., Heyes, R.R., Hunt, J.A., How, T.V., Harris, P.L.: Can intrasac pressure monitoring reliably predict failure of endovascular aneurysm repair? J. Endovasc. Ther. 10, 524–530 (2003)
Vande Geest, J.P., Di Martino, E.S., Bohra, A., Makaroun, M.S., Vorp, D.A.: A biomechanics-based rupture potential index for abdominal aortic aneurysm risk assessment. Ann. NY Acad. Sci. 1085, 11–21 (2006)
Vande Geest, J.P., Wang, D.H.J., Wisniewski, S.R., Makaroun, M.S., Vorp, D.A.: Towards a non-invasive method for determination of patient-specific wall strength distribution in abdominal aortic aneurysms. Ann. Biomed. Eng. 34, 1098–1106 (2006)
Vande Geest, J.P., Sacks, M.S, Vorp, D.A.: The effects of aneurysm on the biaxial mechanical behaviour of human abdominal aorta. J. Biomech. 39, 1324–1334 (2006)
Venkatasubramaniam, A.K., Fagan, M.J., Mehta, T., Mylankal K.J., Ray, B., Kuhan, G., Chetter, I.C., McCollum, P.T.: A comparative study of aortic wall stress using finite element analysis for ruptured and non-ruptured abdominal aortic aneurysms. Eur. J. Vasc. Endovasc. Surg. 28, 168–176 (2004)
Volokh, K.Y., Vorp, D.A.: A model of growth and rupture of abdominal aortic aneurysm. J. Biomech. 41, 1015–1021 (2008)
Vorp, DA.: Biomechanics of abdominal aortic aneurysm. J. Biomech. 40, 1887–1902 (2008)
Vorp, D.A., Raghavan, M.L., Webster, M.W.: Mechanical wall stress in abdominal aortic aneurysm: influence of diameter and asymmetry. J. Vasc. Surg. 27, 632–639 (1998)
Wang, D.H.J., Makaroun, M.S., Webster, M.W., Vorp, D.A.: Mechanical properties and microstructure of intraluminal thrombus from abdominal aortic aneurysm. J. Biomech. Eng. 123, 536–539 (2001)
Wang, D.H.J., Makaroun, M.S., Webster, M.W., Vorp, D.A.: Effect of intraluminal thrombus on wall stress in patient-specific models of abdominal aortic aneurysm. J. Vasc. Surg. 36, 598–604 (2002)
Watton, P., Hill, N., Heil, M.: A mathematical model for the growth of the abdominal aortic aneurysm. Biomech. Model. Mechanobiol. 3(2), 98–113 (2004)
Wilarusmee, C., Suvikrom, J., Suthakorn, J., Lertsithichai, P., Sitthiseriprapip, K., Proprom, N., Kittur, D.S.: Three-dimensional aortic aneurysm model and endovascular repair: an educational tool for surgical trainees. Int. J. Angiol. 17, 129–133 (2008)
Xiong, J., Wang, S.M., Zhou, W., Wu, J.G.: Measurement and analysis of ultimate mechanical properties, stress-strain curve fit, and elastic modulus formula of human abdominal aortic aneurysm and nonaneurysmal abdominal aorta. J. Vasc. Surg. 48, 189–195 (2008)
Zienkiewicz, O.C., Taylor, R.L., Zhu, J.Z.: The finite element method: its basis and fundamentals, 6th edn. Elsevier Butterworth-Heinemann, UK (2005)
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Doyle, B.J., McGloughlin, T.M. (2011). Computer-Aided Diagnosis of Abdominal Aortic Aneurysms. In: McGloughlin, T. (eds) Biomechanics and Mechanobiology of Aneurysms. Studies in Mechanobiology, Tissue Engineering and Biomaterials, vol 7. Springer, Berlin, Heidelberg. https://doi.org/10.1007/8415_2011_70
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