Accuracy of detecting enlargement of aneurysms using different MRI modalities and measurement protocols

Daichi Nakagawa, Yasunori Nagahama, Bruno A. Policeni, Madhavan L. Raghavan, Seth I. Dillard, Anna L. Schumacher, Srivats Sarathy, Brian J. Dlouhy, Saul Wilson, Lauren Allan, Henry H. Woo, John III Huston, Harry J. Cloft, Max Wintermark, James C. Torner, Robert D Jr. Brown, David M. Hasan

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

OBJECTIVE Aneurysm growth is considered predictive of future rupture of intracranial aneurysms. However, how accurately neuroradiologists can reliably detect incremental aneurysm growth using clinical MRI is still unknown. The purpose of this study was to assess the agreement rate of detecting aneurysm enlargement employing generally used MRI modalities. METHODS Three silicone flow phantom models, each with 8 aneurysms of various sizes at different sites, were used in this study. The aneurysm models were identical except for an incremental increase in the sizes of the 8 aneurysms, which ranged from 0.4 mm to 2 mm. The phantoms were imaged on 1.5-T and 3-T MRI units with both time-of-flight (TOF) and contrast-enhanced MR angiography. Three independent expert neuroradiologists measured the aneurysms in a blinded manner using different measurement approaches. The individual and agreement detection rates of aneurysm enlargement among the 3 experts were calculated. RESULTS The mean detection rate of any increase in any aneurysmal dimension was 95.7%. The detection rates of the 3 observers (observers A, B, and C) were 98.0%, 96.6%, and 92.7%, respectively (p = 0.22). The detection rates of each MRI modality were 91.3% using 1.5-T TOF, 97.2% using 1.5-T with Gd, 95.8% using 3.0-T TOF, and 97.2% using 3.0-T with Gd (p = 0.31). On the other hand, the mean detection rate for aneurysm enlargement was 54.8%. Specifically, the detection rates of observers A, B, and C were 49.0%, 46.1%, and 66.7%, respectively (p = 0.009). As the incremental enlargement value increased, the detection rate for aneurysm enlargement increased. The use of 1.5-T Gd improved the detection rate for small incremental enlargement (e.g., 0.4–1 mm) of the aneurysm (p = 0.04). The location of the aneurysm also affected the detection rate for aneurysm enlargement (p < 0.0001). CONCLUSIONS The detection rate and interobserver agreement were very high for aneurysm enlargement of 0.4–2 mm. The detection rate for at least 1 increase in any aneurysm dimension did not depend on the choice of MRI modality or measurement protocol. Use of Gd improved the accuracy of measurement. Aneurysm location may influence the accuracy of detecting enlargement.

Original languageEnglish (US)
Pages (from-to)559-565
Number of pages7
JournalJournal of neurosurgery
Volume130
Issue number2
DOIs
StatePublished - Feb 1 2019

Fingerprint

Aneurysm
Intracranial Aneurysm
Silicones
Growth
Rupture
Angiography

Keywords

  • Aneurysm growth
  • Aneurysm size
  • Detection
  • Magnetic resonance angiography
  • Magnetic resonance imaging
  • Phantom model
  • Vascular disorders

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Nakagawa, D., Nagahama, Y., Policeni, B. A., Raghavan, M. L., Dillard, S. I., Schumacher, A. L., ... Hasan, D. M. (2019). Accuracy of detecting enlargement of aneurysms using different MRI modalities and measurement protocols. Journal of neurosurgery, 130(2), 559-565. https://doi.org/10.3171/2017.9.JNS171811

Accuracy of detecting enlargement of aneurysms using different MRI modalities and measurement protocols. / Nakagawa, Daichi; Nagahama, Yasunori; Policeni, Bruno A.; Raghavan, Madhavan L.; Dillard, Seth I.; Schumacher, Anna L.; Sarathy, Srivats; Dlouhy, Brian J.; Wilson, Saul; Allan, Lauren; Woo, Henry H.; Huston, John III; Cloft, Harry J.; Wintermark, Max; Torner, James C.; Brown, Robert D Jr.; Hasan, David M.

In: Journal of neurosurgery, Vol. 130, No. 2, 01.02.2019, p. 559-565.

Research output: Contribution to journalArticle

Nakagawa, D, Nagahama, Y, Policeni, BA, Raghavan, ML, Dillard, SI, Schumacher, AL, Sarathy, S, Dlouhy, BJ, Wilson, S, Allan, L, Woo, HH, Huston, JIII, Cloft, HJ, Wintermark, M, Torner, JC, Brown, RDJ & Hasan, DM 2019, 'Accuracy of detecting enlargement of aneurysms using different MRI modalities and measurement protocols', Journal of neurosurgery, vol. 130, no. 2, pp. 559-565. https://doi.org/10.3171/2017.9.JNS171811
Nakagawa D, Nagahama Y, Policeni BA, Raghavan ML, Dillard SI, Schumacher AL et al. Accuracy of detecting enlargement of aneurysms using different MRI modalities and measurement protocols. Journal of neurosurgery. 2019 Feb 1;130(2):559-565. https://doi.org/10.3171/2017.9.JNS171811
Nakagawa, Daichi ; Nagahama, Yasunori ; Policeni, Bruno A. ; Raghavan, Madhavan L. ; Dillard, Seth I. ; Schumacher, Anna L. ; Sarathy, Srivats ; Dlouhy, Brian J. ; Wilson, Saul ; Allan, Lauren ; Woo, Henry H. ; Huston, John III ; Cloft, Harry J. ; Wintermark, Max ; Torner, James C. ; Brown, Robert D Jr. ; Hasan, David M. / Accuracy of detecting enlargement of aneurysms using different MRI modalities and measurement protocols. In: Journal of neurosurgery. 2019 ; Vol. 130, No. 2. pp. 559-565.
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title = "Accuracy of detecting enlargement of aneurysms using different MRI modalities and measurement protocols",
abstract = "OBJECTIVE Aneurysm growth is considered predictive of future rupture of intracranial aneurysms. However, how accurately neuroradiologists can reliably detect incremental aneurysm growth using clinical MRI is still unknown. The purpose of this study was to assess the agreement rate of detecting aneurysm enlargement employing generally used MRI modalities. METHODS Three silicone flow phantom models, each with 8 aneurysms of various sizes at different sites, were used in this study. The aneurysm models were identical except for an incremental increase in the sizes of the 8 aneurysms, which ranged from 0.4 mm to 2 mm. The phantoms were imaged on 1.5-T and 3-T MRI units with both time-of-flight (TOF) and contrast-enhanced MR angiography. Three independent expert neuroradiologists measured the aneurysms in a blinded manner using different measurement approaches. The individual and agreement detection rates of aneurysm enlargement among the 3 experts were calculated. RESULTS The mean detection rate of any increase in any aneurysmal dimension was 95.7{\%}. The detection rates of the 3 observers (observers A, B, and C) were 98.0{\%}, 96.6{\%}, and 92.7{\%}, respectively (p = 0.22). The detection rates of each MRI modality were 91.3{\%} using 1.5-T TOF, 97.2{\%} using 1.5-T with Gd, 95.8{\%} using 3.0-T TOF, and 97.2{\%} using 3.0-T with Gd (p = 0.31). On the other hand, the mean detection rate for aneurysm enlargement was 54.8{\%}. Specifically, the detection rates of observers A, B, and C were 49.0{\%}, 46.1{\%}, and 66.7{\%}, respectively (p = 0.009). As the incremental enlargement value increased, the detection rate for aneurysm enlargement increased. The use of 1.5-T Gd improved the detection rate for small incremental enlargement (e.g., 0.4–1 mm) of the aneurysm (p = 0.04). The location of the aneurysm also affected the detection rate for aneurysm enlargement (p < 0.0001). CONCLUSIONS The detection rate and interobserver agreement were very high for aneurysm enlargement of 0.4–2 mm. The detection rate for at least 1 increase in any aneurysm dimension did not depend on the choice of MRI modality or measurement protocol. Use of Gd improved the accuracy of measurement. Aneurysm location may influence the accuracy of detecting enlargement.",
keywords = "Aneurysm growth, Aneurysm size, Detection, Magnetic resonance angiography, Magnetic resonance imaging, Phantom model, Vascular disorders",
author = "Daichi Nakagawa and Yasunori Nagahama and Policeni, {Bruno A.} and Raghavan, {Madhavan L.} and Dillard, {Seth I.} and Schumacher, {Anna L.} and Srivats Sarathy and Dlouhy, {Brian J.} and Saul Wilson and Lauren Allan and Woo, {Henry H.} and Huston, {John III} and Cloft, {Harry J.} and Max Wintermark and Torner, {James C.} and Brown, {Robert D Jr.} and Hasan, {David M.}",
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TY - JOUR

T1 - Accuracy of detecting enlargement of aneurysms using different MRI modalities and measurement protocols

AU - Nakagawa, Daichi

AU - Nagahama, Yasunori

AU - Policeni, Bruno A.

AU - Raghavan, Madhavan L.

AU - Dillard, Seth I.

AU - Schumacher, Anna L.

AU - Sarathy, Srivats

AU - Dlouhy, Brian J.

AU - Wilson, Saul

AU - Allan, Lauren

AU - Woo, Henry H.

AU - Huston, John III

AU - Cloft, Harry J.

AU - Wintermark, Max

AU - Torner, James C.

AU - Brown, Robert D Jr.

AU - Hasan, David M.

PY - 2019/2/1

Y1 - 2019/2/1

N2 - OBJECTIVE Aneurysm growth is considered predictive of future rupture of intracranial aneurysms. However, how accurately neuroradiologists can reliably detect incremental aneurysm growth using clinical MRI is still unknown. The purpose of this study was to assess the agreement rate of detecting aneurysm enlargement employing generally used MRI modalities. METHODS Three silicone flow phantom models, each with 8 aneurysms of various sizes at different sites, were used in this study. The aneurysm models were identical except for an incremental increase in the sizes of the 8 aneurysms, which ranged from 0.4 mm to 2 mm. The phantoms were imaged on 1.5-T and 3-T MRI units with both time-of-flight (TOF) and contrast-enhanced MR angiography. Three independent expert neuroradiologists measured the aneurysms in a blinded manner using different measurement approaches. The individual and agreement detection rates of aneurysm enlargement among the 3 experts were calculated. RESULTS The mean detection rate of any increase in any aneurysmal dimension was 95.7%. The detection rates of the 3 observers (observers A, B, and C) were 98.0%, 96.6%, and 92.7%, respectively (p = 0.22). The detection rates of each MRI modality were 91.3% using 1.5-T TOF, 97.2% using 1.5-T with Gd, 95.8% using 3.0-T TOF, and 97.2% using 3.0-T with Gd (p = 0.31). On the other hand, the mean detection rate for aneurysm enlargement was 54.8%. Specifically, the detection rates of observers A, B, and C were 49.0%, 46.1%, and 66.7%, respectively (p = 0.009). As the incremental enlargement value increased, the detection rate for aneurysm enlargement increased. The use of 1.5-T Gd improved the detection rate for small incremental enlargement (e.g., 0.4–1 mm) of the aneurysm (p = 0.04). The location of the aneurysm also affected the detection rate for aneurysm enlargement (p < 0.0001). CONCLUSIONS The detection rate and interobserver agreement were very high for aneurysm enlargement of 0.4–2 mm. The detection rate for at least 1 increase in any aneurysm dimension did not depend on the choice of MRI modality or measurement protocol. Use of Gd improved the accuracy of measurement. Aneurysm location may influence the accuracy of detecting enlargement.

AB - OBJECTIVE Aneurysm growth is considered predictive of future rupture of intracranial aneurysms. However, how accurately neuroradiologists can reliably detect incremental aneurysm growth using clinical MRI is still unknown. The purpose of this study was to assess the agreement rate of detecting aneurysm enlargement employing generally used MRI modalities. METHODS Three silicone flow phantom models, each with 8 aneurysms of various sizes at different sites, were used in this study. The aneurysm models were identical except for an incremental increase in the sizes of the 8 aneurysms, which ranged from 0.4 mm to 2 mm. The phantoms were imaged on 1.5-T and 3-T MRI units with both time-of-flight (TOF) and contrast-enhanced MR angiography. Three independent expert neuroradiologists measured the aneurysms in a blinded manner using different measurement approaches. The individual and agreement detection rates of aneurysm enlargement among the 3 experts were calculated. RESULTS The mean detection rate of any increase in any aneurysmal dimension was 95.7%. The detection rates of the 3 observers (observers A, B, and C) were 98.0%, 96.6%, and 92.7%, respectively (p = 0.22). The detection rates of each MRI modality were 91.3% using 1.5-T TOF, 97.2% using 1.5-T with Gd, 95.8% using 3.0-T TOF, and 97.2% using 3.0-T with Gd (p = 0.31). On the other hand, the mean detection rate for aneurysm enlargement was 54.8%. Specifically, the detection rates of observers A, B, and C were 49.0%, 46.1%, and 66.7%, respectively (p = 0.009). As the incremental enlargement value increased, the detection rate for aneurysm enlargement increased. The use of 1.5-T Gd improved the detection rate for small incremental enlargement (e.g., 0.4–1 mm) of the aneurysm (p = 0.04). The location of the aneurysm also affected the detection rate for aneurysm enlargement (p < 0.0001). CONCLUSIONS The detection rate and interobserver agreement were very high for aneurysm enlargement of 0.4–2 mm. The detection rate for at least 1 increase in any aneurysm dimension did not depend on the choice of MRI modality or measurement protocol. Use of Gd improved the accuracy of measurement. Aneurysm location may influence the accuracy of detecting enlargement.

KW - Aneurysm growth

KW - Aneurysm size

KW - Detection

KW - Magnetic resonance angiography

KW - Magnetic resonance imaging

KW - Phantom model

KW - Vascular disorders

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U2 - 10.3171/2017.9.JNS171811

DO - 10.3171/2017.9.JNS171811

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JO - Journal of Neurosurgery

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