Automatic CTA analysis for blood vessels and aneurysm features extraction in EVAR planning.

Journal: Scientific reports
PMID:

Abstract

Endovascular Aneurysm Repair (EVAR) is a minimally invasive procedure crucial for treating abdominal aortic aneurysms (AAA), where precise pre-operative planning is essential. Current clinical methods rely on manual measurements, which are time-consuming and prone to errors. Although AI solutions are increasingly being developed to automate aspects of these processes, most existing approaches primarily focus on computing volumes and diameters, falling short of delivering a fully automated pre-operative analysis. This work presents BRAVE (Blood Vessels Recognition and Aneurysms Visualization Enhancement), the first comprehensive AI-driven solution for vascular segmentation and AAA analysis using pre-operative CTA scans. BRAVE offers exhaustive segmentation, identifying both the primary abdominal aorta and secondary vessels, often overlooked by existing methods, providing a complete view of the vascular structure. The pipeline performs advanced volumetric analysis of the aneurysm sac, quantifying thrombotic tissue and calcifications, and automatically identifies the proximal and distal sealing zones, critical for successful EVAR procedures. BRAVE enables fully automated processing, reducing manual intervention and improving clinical workflow efficiency. Trained on a multi-center open-access dataset, it demonstrates generalizability across different CTA protocols and patient populations, ensuring robustness in diverse clinical settings. This solution saves time, ensures precision, and standardizes the process, enhancing vascular surgeons' decision-making.

Authors

  • Erich Robbi
    Department of Information Engineering and Computer Sciences, DISI of University of Trento, Via Sommarive, Trento, 38123, Italy. erich.robbi@unitn.it.
  • Daniele Ravanelli
    Medical Physics Department of Provincial Agency for Health Services of the Autonomous Province of Trento, APSS, S. Chiara Hospital, Trento, 38121, Italy.
  • Sara Allievi
    Vascular Surgery Department of Provincial Agency for Health Services of the Autonomous Province of Trento, APSS, S. Chiara Hospital, Trento, 38121, Italy.
  • Igor Raunig
    Vascular Surgery Department of Provincial Agency for Health Services of the Autonomous Province of Trento, APSS, S. Chiara Hospital, Trento, 38121, Italy.
  • Stefano Bonvini
    Vascular Surgery Department of Provincial Agency for Health Services of the Autonomous Province of Trento, APSS, S. Chiara Hospital, Trento, 38121, Italy.
  • Andrea Passerini
    Department of Information Engineering and Computer Science, University of Trento, Trento, Italy.
  • Annalisa Trianni
    Medical Physics Department of Provincial Agency for Health Services of the Autonomous Province of Trento, APSS, S. Chiara Hospital, Trento, 38121, Italy.