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dc.contributor.authorvan der Marel, Kajo
dc.contributor.authorGounis, Matthew J.
dc.contributor.authorWeaver, John P.
dc.contributor.authorde Korte, Antonius M.
dc.contributor.authorKing, Robert M.
dc.contributor.authorArends, Jennifer M.
dc.contributor.authorBrooks, Olivia W.
dc.contributor.authorWakhloo, Ajay K.
dc.contributor.authorPuri, Ajit S.
dc.date2022-08-11T08:10:46.000
dc.date.accessioned2022-08-23T17:19:38Z
dc.date.available2022-08-23T17:19:38Z
dc.date.issued2016-08-01
dc.date.submitted2017-05-15
dc.identifier.citationJ Neurointerv Surg. 2016 Aug;8(8):847-52. Epub 2015 Jul 28. <a href="https://doi.org/10.1136/neurintsurg-2015-011843">Link to article on publisher's site</a>
dc.identifier.issn1759-8478 (Linking)
dc.identifier.doi10.1136/neurintsurg-2015-011843
dc.identifier.pmid26220411
dc.identifier.urihttp://hdl.handle.net/20.500.14038/48120
dc.description.abstractBACKGROUND: Poor vessel wall apposition of flow diverter (FD) stents poses risks for stroke-related complications when treating intracranial aneurysms, necessitating long-term surveillance imaging. To facilitate quantitative evaluation of deployed devices, a novel algorithm is presented that generates intuitive two-dimensional representations of wall apposition from either high-resolution contrast-enhanced cone-beam CT (VasoCT) or intravascular optical coherence tomography (OCT) images. METHODS: VasoCT and OCT images were obtained after FD implant (n=8 aneurysms) in an experimental sidewall aneurysm model in canines. Surface models of the vessel wall and FD device were extracted, and the distance between them was presented on a two-dimensional flattened map. Maps and cross-sections at potential locations of malapposition detected on VasoCT-based maps were compared. The performance of OCT-based apposition detection was evaluated on manually labeled cross-sections using logistic regression against a thresholded ( > /=0.25 mm) apposition measure. RESULTS: VasoCT and OCT acquisitions yielded similar Grading of Regional Apposition after Flow-Diverter Treatment (GRAFT) apposition maps. GRAFT maps from VasoCT highlighted 16 potential locations of malapposition, of which two were found to represent malapposed device struts. Logistic regression showed that OCT could detect malapposition with a sensitivity of 98% and a specificity of 81%. CONCLUSIONS: GRAFT delivered quantitative and visually convenient representations of potential FD malapposition and occasional acute thrombus formation. A powerful combination for future neuroendovascular applications is foreseen with the superior resolution delivered by intravascular OCT.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=26220411&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttps://doi.org/10.1136/neurintsurg-2015-011843
dc.subjectAneurysm
dc.subjectAngiography
dc.subjectEndoscopy
dc.subjectFlow Diverter
dc.subjectTechnology
dc.subjectNeurology
dc.subjectRadiology
dc.titleGrading of Regional Apposition after Flow-Diverter Treatment (GRAFT): a comparative evaluation of VasoCT and intravascular OCT
dc.typeJournal Article
dc.source.journaltitleJournal of neurointerventional surgery
dc.source.volume8
dc.source.issue8
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/radiology_pubs/225
dc.identifier.contextkey10166371
html.description.abstract<p>BACKGROUND: Poor vessel wall apposition of flow diverter (FD) stents poses risks for stroke-related complications when treating intracranial aneurysms, necessitating long-term surveillance imaging. To facilitate quantitative evaluation of deployed devices, a novel algorithm is presented that generates intuitive two-dimensional representations of wall apposition from either high-resolution contrast-enhanced cone-beam CT (VasoCT) or intravascular optical coherence tomography (OCT) images.</p> <p>METHODS: VasoCT and OCT images were obtained after FD implant (n=8 aneurysms) in an experimental sidewall aneurysm model in canines. Surface models of the vessel wall and FD device were extracted, and the distance between them was presented on a two-dimensional flattened map. Maps and cross-sections at potential locations of malapposition detected on VasoCT-based maps were compared. The performance of OCT-based apposition detection was evaluated on manually labeled cross-sections using logistic regression against a thresholded ( > /=0.25 mm) apposition measure.</p> <p>RESULTS: VasoCT and OCT acquisitions yielded similar Grading of Regional Apposition after Flow-Diverter Treatment (GRAFT) apposition maps. GRAFT maps from VasoCT highlighted 16 potential locations of malapposition, of which two were found to represent malapposed device struts. Logistic regression showed that OCT could detect malapposition with a sensitivity of 98% and a specificity of 81%.</p> <p>CONCLUSIONS: GRAFT delivered quantitative and visually convenient representations of potential FD malapposition and occasional acute thrombus formation. A powerful combination for future neuroendovascular applications is foreseen with the superior resolution delivered by intravascular OCT.</p>
dc.identifier.submissionpathradiology_pubs/225
dc.contributor.departmentDepartment of Neurosurgery
dc.contributor.departmentNew England Center for Stroke Research
dc.contributor.departmentDepartment of Radiology
dc.source.pages847-52


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