Pre-surgical and Post-surgical Aortic Aneurysm Maximum Diameter Measurement: Full Automation by Artificial Intelligence

Objective: The aim of this study was to evaluate an automatic, deep learning based method (Augmented Radiology for Vascular Aneurysm [ARVA]), to detect and assess maximum aortic diameter, providing cross sectional outer to outer aortic wall measurements. Methods: Accurate external aortic wall diameter measurement is performed along the entire aorta, from the ascending aorta to the iliac bifurcations, on both pre- and post-operative contrast enhanced computed tomography angiography (CTA) scans. A training database of 489 CTAs was used to train a pipeline of neural networks for automatic external aortic wall measurements. Another database of 62 CTAs, including controls, aneurysmal aortas, and aortic dissections scanned before and/or after endovascular or open repair, was used for validation. The measurements of maximum external aortic wall diameter made by ARVA were compared with those of seven clinicians on this validation dataset. Results: The median absolute difference with respect to expert's measurements ranged from 1 mm to 2 mm among all annotators, while ARVA reported a median absolute difference of 1.2 mm. Conclusion: The performance of the automatic maximum aortic diameter method falls within the interannotator variability, making it a potentially reliable solution for assisting clinical practice.

Automated summary

This study evaluated an automatic method ARVA for detecting and assessing maximum aortic diameter, showing that the measurements made by ARVA are within the range of interannotator variability, potentially providing a reliable solution for clinical practice.