Determination of accurate stent graft configuration in abdominal aortic aneurysm using computed tomography: a preliminary study☆

Abstract 

An aortic stent graft is frequently used to cure an abdominal aortic aneurysm (AAA). It is critical to accurately fit the size and shape of the stent graft to the target region on the aorta. Proper sizing and shaping require the measurement of the orthogonal diameter of the target region from medical images. The present study aimed to acquire an accurate three-dimensional (3D) reconstruction of the aorta to determine the shape of the cross-sectional area where the stent graft would be implanted. A conventional geometric-active contour model was enhanced to prevent blurring and to improve edge detection with high noise resistivity. After the segmentation of two-dimensional (2D) images using the model, a 3D-reconstructed configuration of the aorta was achieved using a surface-rendering technique. The model could segment several selected synthetic images more accurately than conventional methods. Also, a 3D-reconstructed configuration of the abdominal aorta could be achieved using boundary coordinates extracted from 2D image segmentation. This preliminary study indicates the utility of the approach in optimizing stent graft configuration for AAA patients, thus enhancing stent graft healing.

Keywords: Abdominal aortic aneurysm, Stent graft, Image segmentation, 3D modeling, Morphological gradient edge function