Automatic aortic root landmark detection in CTA images for preprocedural planning of transcatheter aortic valve implantation

Abstract Transcatheter aortic valve implantation is currently a well-established minimal invasive treatment option for patients with severe aortic valve stenosis. CT Angiography is used for the pre-operative planning and sizing of the prosthesis. To reduce the inconsistency in sizing due to interobserver variability, we introduce and evaluate an automatic aortic root landmarks detection method to determine the sizing parameters. The proposed algorithm detects the sinotubular junction, two coronary ostia, and three valvular hinge points on a segmented aortic root surface. Using these aortic root landmarks, the automated method determines annulus radius, annulus orientation, and distance from annulus plane to right and left coronary ostia. Validation is performed by the comparison with manual measurements of two observers for 40 CTA image datasets. Detection of landmarks showed high accuracy where the mean distance between the automatically detected and reference landmarks was 2.81 ± 2.08 mm, comparable to the interobserver variation of 2.67 ± 2.52 mm. The mean annulus to coronary ostium distance was 16.9 ± 3.3 and 17.1 ± 3.3 mm for the automated and the reference manual measurements, respectively, with a mean paired difference of 1.89 ± 1.71 mm and interobserver mean paired difference of 1.38 ± 1.52 mm. Automated detection of aortic root l...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research

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Assessment of the severity of internal carotid artery stenosis is relevant to therapeutic decisions. Direct measurement of stenosis in static three-dimensionally rendered ultrasonographic color-Doppler images after an orientation with 4-D gray-scale views (4D/3D-C-US) was recently observed to be metrically non-inferior to angiography. In the study described here, power-Doppler (Christian Doppler was a physicist) ultrasonography (4D/3D-P-US) was prospectively compared with angiography, 4D/3D-C-US and 2-D duplex ultrasonography (DUS) in a similar fashion using blinded observers.
Source: Ultrasound in Medicine and Biology - Category: Radiology Authors: Tags: Original Contribution Source Type: research
ConclusionsPosterior fossa AVMs may have some distinct features compared with supratentorial AVMs. The available reports on pfAVMs are not sufficiently standardized to provide reliable guidance for patient management decisions. This goal will require future studies to be multicentric and to focus on standardized, repeatable clinical and angiographic outcomes.
Source: Acta Neurochirurgica - Category: Neurosurgery Source Type: research
Conclusion: To our knowledge, this is the first report in which an immediate thrombus formation on the carotid web was observed in a patient with congenital protein C deficiency. In a case of acute ischemic stroke with carotid web, especially when congenital coagulopathy such as protein C deficiency is suspected, careful follow-up with ultrasound imaging should be performed.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
DiscussionIn hindsight I feel there are very few alternative causes for an ECG like this other than an acute LAD occlusion. I believe this is one of those'subtle STEMI'cases where neither the ECG nor the symptoms are very obvious or severe and the usual evolution is not seen.I think of these cases as'insidious infarcts'and I have seen this in all infarct territories and I do not think they are particularly rare. Essentially the patient is fairly comfortable and the ECG is not obvious but the patient ended up with Q waves, huge troponins and we missed the opportunity to reperfuse the artery when it counts. These patients te...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
The original version of this article, published on 01 April 2019, unfortunately contained a mistake. The presentation of Fig. 1 was incorrect. The corrected figure is given below.
Source: European Radiology - Category: Radiology Source Type: research
ConclusionThe vessel-specific MCP myocardial perfusion territory assignment technique more accurately quantifies LCA and RCA perfusion territories as compared with the current standard AHA 17-segment model. Therefore, it can potentially provide a more comprehensive and patient-specific evaluation of coronary artery disease.Key Points• The minimum cost path (MCP) technique accurately determines left and right coronary artery perfusion territories, as compared with the American Heart Association 17-segment (AHA) model.• The minimum cost path (MCP) technique could be applied to cardiac computed-tomography angiograph...
Source: European Radiology - Category: Radiology Source Type: research
Condition:   Coronary Artery Disease Interventions:   Diagnostic Test: CT angiography;   Diagnostic Test: Invasive coronary angiography Sponsors:   Johns Hopkins University;   Canon Medical Systems Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
AbstractPeripheral artery disease (PAD) is associated with high cardiovascular mortality. Which part of PAD with lower extremities is related to coronary artery disease (CAD) remains unknown. We hypothesized that PAD including infrapopliteal artery (IPA) occlusion was associated with CAD. A total of 260 patients who have no history of CAD or the anginal symptom, complain of the claudication or critical limb ischemia and underwent peripheral angiography were retrospectively analyzed. IPA occlusion was diagnosed with peripheral angiography, and CAD was diagnosed with the coronary angiography. A multivariate logistic regressi...
Source: Heart and Vessels - Category: Cardiology Source Type: research
CONCLUSIONSIn patients with NICM, lower sMBF predicts VA. This relationship may be useful for risk stratification for ventricular arrhythmia and decision ‐making regarding ICD implantation.This article is protected by copyright. All rights reserved.
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
I'm a CT surgery junior resident doing a 1 month cath rotation in a few months. I was wondering if there was a good handbook in interv cardio that you would recommend? I'm looking for something that ideally would provide me with what I need to know as a surgeon, something that is easy to read from cover to cover and covers the basics and fundamentals without going into too many details or being overly complex. My learning goals for the rotation are to be able to read coronary angiograms... Good textbook for cardiac cath/interv cardio for a surgical resident?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Cardiology Source Type: forums
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