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Carbon dioxide cone-beam computed tomography for the technical assessment of endovascular aortic intervention.

ABSTRACT: Cone-beam computed tomography (CBCT) is widely used for the technical assessment of standard and complex endovascular aortic interventions. Use of iodinated contrast in CBCT imaging might provide useful additional information; however, this also increases the procedural contrast dose, which may cause renal function deterioration, and the radiation exposure. We describe the technique and feasibility of carbon-dioxide (CO2)-enhanced CBCT for the technical assessment of standard and complex endovascular aortic repair. In our experience CO2-CBCT had no related adverse events and provided satisfactory imaging quality to assess endograft integrity, vessels patency, and was safely performed in case of severe chronic renal insufficiency.

SUBMITTER: Antonello M

PROVIDER: S-EPMC11372803 | biostudies-literature | 2024 Oct

REPOSITORIES: biostudies-literature

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Carbon dioxide cone-beam computed tomography for the technical assessment of endovascular aortic intervention.

Antonello Michele M Bilato Marco James MJ Menara Sabrina S Grego Franco F Piazza Michele M Squizzato Francesco F

Journal of vascular surgery cases and innovative techniques 20240722 5

Cone-beam computed tomography (CBCT) is widely used for the technical assessment of standard and complex endovascular aortic interventions. Use of iodinated contrast in CBCT imaging might provide useful additional information; however, this also increases the procedural contrast dose, which may cause renal function deterioration, and the radiation exposure. We describe the technique and feasibility of carbon-dioxide (CO<sub>2</sub>)-enhanced CBCT for the technical assessment of standard and comp ...[more]

PMID: 39234560

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Project description:PurposeAnastomosis between posterior superior alveolar artery and infraorbital artery can go through bony canal in the lateral wall of the maxilla. This artery is called alveolar antral artery. It can complicate lateral sinus lift procedure by bleeding and hemosinus formation or bone graft wash out. The artery can also go in soft tissues where is not visible on cone beam computed tomography. In previous studies, the relation of this artery to sinus floor or alveolar process was measured. These structures are highly unstable during lifetime and after tooth loss. The aim of this study is to study presence and relations of bony canal in the lateral maxillary wall, to characterize the group of patients which is more likely to have bone canal in the lateral maxilla. The aim and the novelty of this study is the describing of the relationship of the bony canal to the more stable structure of hard palate and describing the relation of presence of bony canal on width of maxillary sinus, and to facilitate the prediction of presence of the alveolar antral artery.MaterialsThe cone beam computed tomography scans of the patients (251 in number) of the university hospital were examined for presence of alveolar antral artery (148 was fulfilled inclusion criteria), patient were characterized by gender, age, and sinus type (wide, average, narrow). The diameter of the bony canal and its relation to the level of sinus floor and hard palate were measured.ResultsThe cone beam computed tomography scans of 148 patients, out of it 55 man (37,2%) and 93 women (62,8%). Bony canal containing alveolar anastomosis was found in 69 cases (57,0%). Presence of the bony canal in the lateral wall of maxillae showed statistical probability depending on age with p = 0, 064 according to Mann-Whitney test. The older patients have more likely the bony canal. The presence of the alveolar antral artery was found more likely in the wide sinuses. The hard palate level can serve as a prediction point of alveolar antral artery only in first molar and second premolar region. In accordance with previous studies the width of bony canal is significantly higher in group of man (p = 0, 015). There was found a correlation between smaller distance of bony canal from sinus floor in the presence of teeth (p = 0, 067). After tooth loss the distance between sinus floor and bony canal increases, but the distance of bony canal to hard palate level stays constant. This can be explained hypothetically so that periodontal ligaments and root surface acts as a barrier for sinus pneumatization.ConclusionLateral sinus lifting in some cases can be unenviable, the knowledge about alveolar antral artery anatomy can reduce the risk of arterial bleeding. The cone-beam computed tomography is a routine examination prior to augmentation surgery and therefore the data obtained from it has an impact on clinical practice.

Project description:BackgroundCurrent medical image registration methods based on Transformer still encounter challenges, including significant local intensity differences and limited computational efficiency when dealing with three-dimensional (3D) computed tomography (CT) and cone beam CT (CBCT) images. These limitations hinder the precise alignment necessary for effective diagnosis and treatment planning. Therefore, the aim of this study is to develop a novel method that overcomes these challenges by enhancing feature interaction and computational efficiency in 3D medical image registration.MethodsThis paper introduces a novel method that enhances feature interaction within Transformer by computing attention within resizable spatial perpendicular window (SPW). Additionally, it introduces a self-learning mapping control (SLMC) mechanism, which uses a mini convolutional neural network (CNN) to adaptively transform feature vectors into probability vectors. This approach is integrated into the UNet framework, resulting in the SPW-TransUNet. The effectiveness of the SPW-TransUNet is demonstrated through evaluations on two critical 3D medical imaging tasks: CT-CBCT registration and inter-CT registration. We utilized a range of evaluation metrics including Dice similarity coefficient (DICE), structural similarity index measure (SSIM), target registration error (TRE), and negative Jacobian percentage. The validation process involved comparative analysis against established baseline methods using statistical tests to ensure the robustness and reliability of our results.ResultsThe proposed method demonstrated outstanding performance in the registration of 124 pairs of CT-CBCT lung images from 20 patients, achieving the lowest TRE of 2.16 mm and a minimal negative Jacobian of 0.126. It also recorded the highest SSIM and Dice coefficient of 86.87% and 88.28%, respectively. For the liver CT task involving 150 patients, the method achieved peak SSIM and DICE scores of 76.92% and 85.77%, respectively. Furthermore, ablation studies confirmed the effectiveness of the designed structural components.ConclusionsThe SPW-TransUNet offers significant improvements in feature interaction and computational efficiency for medical image registration, providing an effective reference solution for patient and target localization in image-guided radiation therapy.

Dataset Information

Carbon dioxide cone-beam computed tomography for the technical assessment of endovascular aortic intervention.

Publications

Carbon dioxide cone-beam computed tomography for the technical assessment of endovascular aortic intervention.

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