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PT  - JOURNAL ARTICLE
AU  - Lang, S.
AU  - Hoelter, P.
AU  - Schmidt, M.
AU  - Strother, C.
AU  - Kaethner, C.
AU  - Kowarschik, M.
AU  - Doerfler, A.
TI  - Artificial Intelligence–Based 3D Angiography for Visualization of Complex Cerebrovascular Pathologies
AID  - 10.3174/ajnr.A7252
DP  - 2021 Oct 01
TA  - American Journal of Neuroradiology
PG  - 1762--1768
VI  - 42
IP  - 10
4099  - http://www.ajnr.org/content/42/10/1762.short
4100  - http://www.ajnr.org/content/42/10/1762.full
SO  - Am. J. Neuroradiol.2021 Oct 01; 42
AB  - BACKGROUND AND PURPOSE: By means of artificial intelligence, 3D angiography is a novel postprocessing method for 3D imaging of cerebral vessels. Because 3D angiography does not require a mask run like the current standard 3D-DSA, it potentially offers a considerable reduction of the patient radiation dose. Our aim was an assessment of the diagnostic value of 3D angiography for visualization of cerebrovascular pathologies.MATERIALS AND METHODS: 3D-DSA data sets of cerebral aneurysms (nCA = 10), AVMs (nAVM = 10), and dural arteriovenous fistulas (dAVFs) (ndAVF = 10) were reconstructed using both conventional and prototype software. Corresponding reconstructions have been analyzed by 2 neuroradiologists in a consensus reading in terms of image quality, injection vessel diameters (vessel diameter [VD] 1/2), vessel geometry index (VGI = VD1/VD2), and specific qualitative/quantitative parameters of AVMs (eg, location, nidus size, feeder, associated aneurysms, drainage, Spetzler-Martin score), dAVFs (eg, fistulous point, main feeder, diameter of the main feeder, drainage), and cerebral aneurysms (location, neck, size).RESULTS: In total, 60 volumes have been successfully reconstructed with equivalent image quality. The specific qualitative/quantitative assessment of 3D angiography revealed nearly complete accordance with 3D-DSA in AVMs (eg, mean nidus size3D angiography/3D-DSA= 19.9 [SD, 10.9]/20.2 [SD, 11.2] mm; r = 0.9, P = .001), dAVFs (eg, mean diameter of the main feeder3D angiography/3D-DSA= 2.04 [SD, 0.65]/2.05 [SD, 0.63] mm; r = 0.9, P = .001), and cerebral aneurysms (eg, mean size3D angiography/3D-DSA= 5.17 [SD, 3.4]/5.12 [SD, 3.3] mm; r = 0.9, P = .001). Assessment of the geometry of the injection vessel in 3D angiography data sets did not differ significantly from that of 3D-DSA (vessel geometry indexAVM: r = 0.84, P = .003; vessel geometry indexdAVF: r = 0.82, P = .003; vessel geometry indexCA: r = 0.84, P <.001).CONCLUSIONS: In this study, the artificial intelligence–based 3D angiography was a reliable method for visualization of complex cerebrovascular pathologies and showed results comparable with those of 3D-DSA. Thus, 3D angiography is a promising postprocessing method that provides a significant reduction of the patient radiation doseAIartificial intelligenceCAcerebral aneurysmdAVFdural arteriovenous fistula3DA3D angiography3D-DSA3D digital subtraction angiographyVDvessel diameterVGIvessel geometry indexVRTvolume rendering technique