Geometric uncertainty in intracranial aneurysm rupture status discrimination: a two-site retrospective study.

Hellmeier, Florian; Brüning, Jan; Berg, Philipp; Saalfeld, Sylvia; Spuler, Andreas; Sandalcioglu, Ibrahim Erol; Beuing, Oliver; Larsen, Naomi; Schaller, Jens; Goubergrits, Leonid

doi:10.1136/bmjopen-2022-063051

by Florian Hellmeier, Jan Brüning, Philipp Berg, Sylvia Saalfeld, Andreas Spuler, Ibrahim Erol Sandalcioglu, Oliver Beuing, Naomi Larsen, Jens Schaller, Leonid Goubergrits

Abstract:

OBJECTIVES: Assessing the risk associated with unruptured intracranial aneurysms (IAs) is essential in clinical decision making. Several geometric risk parameters have been proposed for this purpose. However, performance of these parameters has been inconsistent. This study evaluates the performance and robustness of geometric risk parameters on two datasets and compare it to the uncertainty inherent in assessing these parameters and quantifies interparameter correlations. METHODS: Two datasets containing 244 ruptured and unruptured IA geometries from 178 patients were retrospectively analysed. IAs were stratified by anatomical region, based on the PHASES score locations. 37 geometric risk parameters representing four groups (size, neck, non-dimensional, and curvature parameters) were assessed. Analysis included standardised absolute group differences (SADs) between ruptured and unruptured IAs, ratios of SAD to median relative uncertainty (MRU) associated with the parameters, and interparameter correlation. RESULTS: The ratio of SAD to MRU was lower for higher dimensional size parameters (ie, areas and volumes) than for one-dimensional size parameters. Non-dimensional size parameters performed comparatively well with regard to SAD and MRU. SAD was higher in the posterior anatomical region. Correlation of parameters was strongest within parameter (sub)groups and between size and curvature parameters, while anatomical region did not strongly affect correlation patterns. CONCLUSION: Non-dimensional parameters and few parameters from other groups were comparatively robust, suggesting that they might generalise better to other datasets. The data on discriminative performance and interparameter correlations presented in this study may aid in developing and choosing robust geometric parameters for use in rupture risk models.

Reference:

Geometric uncertainty in intracranial aneurysm rupture status discrimination: a two-site retrospective study. (Florian Hellmeier, Jan Brüning, Philipp Berg, Sylvia Saalfeld, Andreas Spuler, Ibrahim Erol Sandalcioglu, Oliver Beuing, Naomi Larsen, Jens Schaller, Leonid Goubergrits), In BMJ open, volume 12, 2022.

Bibtex Entry:

@article{hellmeier_geometric_2022,
	title = {Geometric uncertainty in intracranial aneurysm rupture status discrimination: a  two-site retrospective study.},
	volume = {12},
	copyright = {© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No  commercial re-use. See rights and permissions. Published by BMJ.},
	issn = {2044-6055 2044-6055},
	doi = {10.1136/bmjopen-2022-063051},
	abstract = {OBJECTIVES: Assessing the risk associated with unruptured intracranial aneurysms  (IAs) is essential in clinical decision making. Several geometric risk parameters  have been proposed for this purpose. However, performance of these parameters has  been inconsistent. This study evaluates the performance and robustness of  geometric risk parameters on two datasets and compare it to the uncertainty  inherent in assessing these parameters and quantifies interparameter  correlations. METHODS: Two datasets containing 244 ruptured and unruptured IA  geometries from 178 patients were retrospectively analysed. IAs were stratified  by anatomical region, based on the PHASES score locations. 37 geometric risk  parameters representing four groups (size, neck, non-dimensional, and curvature  parameters) were assessed. Analysis included standardised absolute group  differences (SADs) between ruptured and unruptured IAs, ratios of SAD to median  relative uncertainty (MRU) associated with the parameters, and interparameter  correlation. RESULTS: The ratio of SAD to MRU was lower for higher dimensional  size parameters (ie, areas and volumes) than for one-dimensional size parameters.  Non-dimensional size parameters performed comparatively well with regard to SAD  and MRU. SAD was higher in the posterior anatomical region. Correlation of  parameters was strongest within parameter (sub)groups and between size and  curvature parameters, while anatomical region did not strongly affect correlation  patterns. CONCLUSION: Non-dimensional parameters and few parameters from other  groups were comparatively robust, suggesting that they might generalise better to  other datasets. The data on discriminative performance and interparameter  correlations presented in this study may aid in developing and choosing robust  geometric parameters for use in rupture risk models.},
	language = {eng},
	number = {11},
	journal = {BMJ open},
	author = {Hellmeier, Florian and Brüning, Jan and Berg, Philipp and Saalfeld, Sylvia and Spuler, Andreas and Sandalcioglu, Ibrahim Erol and Beuing, Oliver and Larsen, Naomi and Schaller, Jens and Goubergrits, Leonid},
	month = nov,
	year = {2022},
	pmid = {36351732},
	pmcid = {PMC9644336},
	keywords = {*Aneurysm, Ruptured, *Intracranial Aneurysm, Cerebral Angiography/methods, Humans, Neck, neurology, neuroradiology, neurosurgery, Retrospective Studies, Risk Factors, Uncertainty},
	pages = {e063051}
}