Objectives To develop and evaluate a fully automatic method to measure diameters of the ascending and descending aorta on non-ECG-gated, non-contrast computed tomography (CT) scans. Material and methods The method combines multi-atlas registration to obtain seed points, aorta centerline extraction, and an optimal surface segmentation approach to extract the aorta surface around the centerline. From the extracted 3D aorta segmentation, the diameter of the ascending and descending aorta was calculated at cross-sectional slices perpendicular to the extracted centerline, at the level of the pulmonary artery bifurcation, and at 1-cm intervals up to 3 cm above and below this level. Agreement with manual annotations was evaluated by dice similarity coefficient (DSC) for segmentation overlap, mean surface distance (MSD), and intra-class correlation (ICC) of diameters on 100 CT scans from a lung cancer screening trial. Repeatability of the diameter measurements was evaluated on 617 baseline-one year follow-up CT scan pairs. Results The agreement between manual and automatic segmentations was good with 0.95 ± 0.01 DSC and 0.56 ± 0.08 mm MSD. ICC between the diameters derived from manual and from automatic segmentations was 0.97, with the per-level ICC ranging from 0.87 to 0.94. An ICC of 0.98 for all measurements and per-level ICC ranging from 0.91 to 0.96 were obtained for repeatability. Conclusion This fully automatic method can assess diameters in the thoracic aorta reliably even in non-ECG-gated, non-contrast CT scans. This could be a promising tool to assess aorta dilatation in screening and in clinical practice.

Additional Metadata
Keywords Thoracic aorta . Dilatation . Computer-assisted image analysis . Three-dimensional image . Computed tomography, X-ray
Persistent URL dx.doi.org/10.1007/s00330-018-5931-z, hdl.handle.net/1765/119409
Journal European Radiology: journal of the European Congress of Radiology
Gamechi, Z.S., Bons, L.R., Giordano, M., Bos, D, Budde, R.P.J., Kofoed, K.F., … de Bruijne, M. (2019). Automated 3D segmentation and diameter measurement of the thoracic aorta on non-contrast enhanced CT. European Radiology: journal of the European Congress of Radiology, 29(9), 4613–4623. doi:10.1007/s00330-018-5931-z