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Clinical Neuroradiology
Published in: Clinical Neuroradiology 1/2016

01-03-2016 | Original Article

Aneurysm Recurrence Volumetry Is More Sensitive than Visual Evaluation of Aneurysm Recurrences

Authors: M.H. Schönfeld, V. Schlotfeldt, N.D. Forkert, E. Goebell, M. Groth, E. Vettorazzi, Y.D. Cho, M.H. Han, H.-S. Kang, J. Fiehler

Published in: Clinical Neuroradiology | Issue 1/2016

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Abstract

Purpose

Considerable inter-observer variability in the visual assessment of aneurysm recurrences limits its use as an outcome parameter evaluating new coil generations. The purpose of this study was to compare visual assessment of aneurysm recurrences and aneurysm recurrence volumetry with an example dataset of HydroSoft coils (HSC) versus bare platinum coils (BPC).

Methods

For this retrospective study, 3-dimensional time-of-flight magnetic resonance angiography datasets acquired 6 and 12 months after endovascular therapy using BPC only or mainly HSC were analyzed. Aneurysm recurrence volumes were visually rated by two observersas well as quantified by subtraction of the datasets after intensity-based rigid registration.

Results

A total of 297 aneurysms were analyzed (BPC: 169, HSC: 128). Recurrences were detected by aneurysm recurrence volumetry in 9 of 128 (7.0 %) treated with HSC and in 24 of 169 (14.2 %) treated with BPC (odds ratio: 2.39, 95 % confidence interval: 1.05–5.48; P = 0.039). Aneurysm recurrence volumetry revealed an excellent correlation between observers (Cronbach’s alpha = 0.93). In contrast, no significant difference in aneurysm recurrence was found for visual assessment (3.9 % in HSC cases and 4.7 % in BPC cases). Recurrences were observed in aneurysms smaller than the sample median in 10 of 33 (30.3 %) by aneurysm recurrence volumetry and in 1 of 13 (7.7 %) by visual assessment.

Conclusions

Aneurysm recurrences were detected more frequently by aneurysm recurrence volumetry when compared with visual assessment. By using aneurysm recurrence volumetry, differences between treatment groups were detected with higher sensitivity and inter-observer validity probably because of the higher detection rate of recurrences in small aneurysms.
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Metadata
Title
Aneurysm Recurrence Volumetry Is More Sensitive than Visual Evaluation of Aneurysm Recurrences
Authors
M.H. Schönfeld
V. Schlotfeldt
N.D. Forkert
E. Goebell
M. Groth
E. Vettorazzi
Y.D. Cho
M.H. Han
H.-S. Kang
J. Fiehler
Publication date
01-03-2016
Publisher
Springer Berlin Heidelberg
Published in
Clinical Neuroradiology / Issue 1/2016
Print ISSN: 1869-1439
Electronic ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-014-0330-6

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