TY - JOUR
T1 - Volumetric quantification of type II endoleaks
T2 - An indicator for aneurysm sac growth following endovascular abdominal aortic aneurysm repair
AU - Demehri, Shadpour
AU - Signorelli, Jason
AU - Kumamaru, Kanako K.
AU - Wake, Nicole
AU - George, Elizabeth
AU - Hanley, Michael
AU - Steinger, Michael L.
AU - Gravereaux, Edwin Charles
AU - Rybicki, Frank J.
PY - 2014/4
Y1 - 2014/4
N2 - Purpose: To test the hypothesis that type II endoleak cavity volume (ECV) and endoleak cavity diameter (ECD) measurements are accurate indicators of aneurysm sac volume (ASV) enlargement in patients who undergo endovascular aneurysm repair (EVAR) in the abdominal aorta. Materials and Methods: The institutional review board approved and waived the need to obtain patient consent for this HIPAA-compliant retrospective study. In 72 patients who underwent EVAR, 160 computed tomographic (CT) angiography studies revealed type II endoleaks. Corresponding to these 160 CT angiography studies, 113 CT follow-up studies (in 52 patients) were available and were included in the analysis. ECV measurements were obtained by two observers in consensus by using arterial enhanced phase (ECVAEP) and 70-second delayed enhanced phase (ECVDEP) CT images. The ECVDEP was also normalized as the ECV/ASV ratio. Maximum (ECDM) and transverse (ECDT) ECDs were determined from delayed enhanced phase images. The outcome was determined as interval increase (>2%) in ASV versus stable or decreasing (≤2%) ASV. Receiver operating characteristic (ROC) analysis was used to compare the accuracy of type II ECV and ECD measurements in indicating interval increase in ASV. Results: In 56 (49.5%) of 113 CT studies in type II endoleaks, there was an interval increase in ASV. The accuracies of ECVDEP (area under the ROC curve [AUC], 0.85) and normalized ECVDEP (AUC, 0.86) were superior to the accuracies of ECDM (AUC, 0.73), ECDT (AUC, 0.73), and ECVAEP (AUC, 0.66). At ROC curve analysis, the sensitivity, specificity, and positive and negative predictive values for type II endoleak cavities with an ECVDEP of less than 0.5 mL for showing no future sac volume enlargement were 33% (19 of 57), 100% (56 of 56), 100% (19 of 19), and 60% (56 of 94), respectively. Conclusion: With use of the delayed enhanced phase of CT angiography, ECV measurement is an accurate indicator of aneurysm sac enlargement.
AB - Purpose: To test the hypothesis that type II endoleak cavity volume (ECV) and endoleak cavity diameter (ECD) measurements are accurate indicators of aneurysm sac volume (ASV) enlargement in patients who undergo endovascular aneurysm repair (EVAR) in the abdominal aorta. Materials and Methods: The institutional review board approved and waived the need to obtain patient consent for this HIPAA-compliant retrospective study. In 72 patients who underwent EVAR, 160 computed tomographic (CT) angiography studies revealed type II endoleaks. Corresponding to these 160 CT angiography studies, 113 CT follow-up studies (in 52 patients) were available and were included in the analysis. ECV measurements were obtained by two observers in consensus by using arterial enhanced phase (ECVAEP) and 70-second delayed enhanced phase (ECVDEP) CT images. The ECVDEP was also normalized as the ECV/ASV ratio. Maximum (ECDM) and transverse (ECDT) ECDs were determined from delayed enhanced phase images. The outcome was determined as interval increase (>2%) in ASV versus stable or decreasing (≤2%) ASV. Receiver operating characteristic (ROC) analysis was used to compare the accuracy of type II ECV and ECD measurements in indicating interval increase in ASV. Results: In 56 (49.5%) of 113 CT studies in type II endoleaks, there was an interval increase in ASV. The accuracies of ECVDEP (area under the ROC curve [AUC], 0.85) and normalized ECVDEP (AUC, 0.86) were superior to the accuracies of ECDM (AUC, 0.73), ECDT (AUC, 0.73), and ECVAEP (AUC, 0.66). At ROC curve analysis, the sensitivity, specificity, and positive and negative predictive values for type II endoleak cavities with an ECVDEP of less than 0.5 mL for showing no future sac volume enlargement were 33% (19 of 57), 100% (56 of 56), 100% (19 of 19), and 60% (56 of 94), respectively. Conclusion: With use of the delayed enhanced phase of CT angiography, ECV measurement is an accurate indicator of aneurysm sac enlargement.
UR - http://www.scopus.com/inward/record.url?scp=84896949733&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84896949733&partnerID=8YFLogxK
U2 - 10.1148/radiol.13130157
DO - 10.1148/radiol.13130157
M3 - Article
C2 - 24475801
AN - SCOPUS:84896949733
SN - 0033-8419
VL - 271
SP - 282
EP - 290
JO - Radiology
JF - Radiology
IS - 1
ER -