J Korean Neurosurg Soc.  2021 Jul;64(4):514-523. 10.3340/jkns.2020.0255.

An Efficient Method for Aneurysm Volume Quantification Applicable in Any Shape and Modalities

• Chung J
• Ko JH

• KMID: 2517684
• DOI: http://doi.org/10.3340/jkns.2020.0255

Abstract

Objective
: Aneurysm volume quantification (AVQ) using the equation of ellipsoid volume is widely used although it is inaccurate. Furthermore, AVQ with 3-dimensional (3D) rendered data has limitations in general use. A novel universal method for AVQ is introduced for any diagnostic modality and application to any shape of aneurysms.
Methods
: Relevant AVQ studies published from January 1997 to June 2019 were identified to determine common methods of AVQ. The basic idea is to eliminate the normal artery volume from 3D model with the aneurysm. After Digital Imaging and Communications in Medicine (DICOM) data is converted and exported to stereolithography (STL) file format, the 3D STL model is modified to remove the aneurysm and the volume difference between the 3D model with/without the aneurysm is defined as the aneurysm volume. Fifty randomly selected aneurysms from DICOM database were used to validate the different AVQ methods.
Results
: We reviewed and categorized AVQ methods in 121 studies. Approximately 60% used the ellipsoid method, while 24% used the 3D model. For 50 randomly selected aneurysms, volumes were measured using 3D Slicer, RadiAnt, and ellipsoid method. Using 3D Slicer as the reference, the ratios of mean difference to mean volume obtained by RadiAnt and ellipsoid method were -1.21±7.46% and 4.04±30.54%, respectively. The deviations between RadiAnt and 3D Slicer were small despite of aneurysm shapes, but those of ellipsoid method and 3D Slicer were large.
Conclusion
: In spite of inaccuracy, ellipsoid method is still mostly used. We propose a novel universal method for AVQ that is valid, low cost, and easy to use.

Keyword

Intracranial aneurysm; Volume quantification; Ellipsoid method; 3D model

Figure

• 

  Fig. 1. Aneurysm volume of saccular and fusiform aneurysm. A : Classically, aneurysm volume can be defined as an outpouching lesion above the aneurysm neck in the saccular aneurysm. B : However, aneurysm neck may be frustrating in the fusiform aneurysm. C and D : Therefore, in this paper, the aneurysm volume is defined as the volume of the remaining part after removing the artery component.

• 

  Fig. 2. The basic concept of the proposed novel aneurysm volume quantification method. Digital Imaging and Communications in Medicine data is converted to the 3-dimensional (3D) model and exported to a 3D STL file format. This 3D to stereolithography (STL) model is modified to reach the normal vasculature. The volume difference between 3D STL model with/without the aneurysm is defined as the aneurysm volume.

• 

  Fig. 3. The trend of aneurysm volume quantification (AVQ) methods. The ellipsoid method is still a major AVQ method although its limitations (approximately 60%). AVQ method using the 3-dimensional model does not exceed one third in 5 year basis. N/A : not applicable.

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  Fig. 4. A and B : Bland-Altman plots of RadiAnt-3-dimensional (3D) slicer and ellipsoid method-3D slicer. Standard deviation in Bland-Altman plots of RadiAnt-3D slicer is within 10% of mean volume difference while standard deviation in Bland-Altman plots of ellipsoid method-3D slicer is beyond 10% of mean volume difference. Red line : 10% volume difference reference line, Black broken line : standard deviation, Blue broken line : mean volume difference to mean volume in percentile.

• 

  Fig. 5. Comparison of Bland-Altman plots by different aneurysm shapes. The standard deviation in Bland-Altman plots of RadiAnt-3-dimensional (3D) slicer is within 10% of mean volume difference in both non-lobulated and lobulated aneurysm shape (A and C). On the contrary, the standard deviation in Bland-Altman plots of ellipsoid method-3D slicer is beyond 10% of mean volume difference (B and D). Bland-Altman plots of RadiAnt-3D slicer in fusiform aneurysm is also demonstrated to show that current aneurysm volume quantification method is also applicable in fusiform aneurysm (E). Red line : reference line of 10% volume difference, Black broken line : standard deviation, Blue broken line : mean volume difference to mean volume in percentile.

Reference

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