Hereditary hemorrhagic telangiectasia (HHT) is an autosomic dominant disorder, which is characterized by the development of multiple arterio-venous malformations in the skin, mucous membranes, and/or visceral organs. Pulmonary Arterio-Venous Malformation (PAVM) is an abnormal connection where feeding arteries shunt directly into draining veins with no intervening capillary bed. This condition may lead to paradoxical embolism and hemorrhagic complications. PAVMs patients should systematically be screened as the spontaneous complication rate is high, reaching almost 50%. Chest enhanced contrast CT scanner is the reference screening and follow-up examination. When performed by experienced operators as the prime treatment, percutaneous embolization of PAVMs is a safe, efficient and sustained therapy. The accuracy of PAVM detection and quantification of its progression over time is the key of embolotherapy success. In this paper, we propose an automatic method for PAVM detection and quantification relying on a modeling of vessel deformation, i.e. local caliber increase, based on mathematical morphology. The pulmonary field and vessels are first segmented using geodesic operators. The vessel caliber is estimated by means of a granulometric measure and the local caliber increase is detected by using a geodesic operator, the h-maxdomes. The detection sensitivity can be tuned up according to the choice of the h value which models the irregularity of the vessel caliber along its axis and the PAVM selection is performed according to a clinical criterion of >3 mm diameter of the feeding artery of the PAVM. The developed method was tested on a 20 patient dataset. A sensitivity study allowed choosing the irregularity parameter to maximize the true positive ratio reaching 85.4% in average. A specific false positive reduction procedure targeting the vessel trunks of the arterio-venous tree near mediastinum allows a precision increase from 13% to 67% with an average number of 1.15 false positives per scan.
Catalin Fetita, Thierry Fortemps de Loneux, Amélé Florence Kouvahe, and Mostafa El Hajjam, "Automatic detection and quantification of pulmonary arterio-venous malformations in hereditary hemorrhagic telangiectasia," Proc. SPIE 10134, Medical Imaging 2017: Computer-Aided Diagnosis, 1013419 (Presented at SPIE Medical Imaging: February 15, 2017; Published: 3 March 2017); https://doi.org/10.1117/12.2254754.
Conference Presentations are recordings of oral presentations given at SPIE conferences and published as part of the conference proceedings. They include the speaker's narration along with a video recording of the presentation slides and animations. Many conference presentations also include full-text papers. Search and browse our growing collection of more than 12,000 conference presentations, including many plenary and keynote presentations.