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Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
Mar 28, 2025;

Quantitative Analysis of 3D Anatomy to Inform Planning of Ductal Arteriosus Stenting.

Mudit Gupta, Silvani Amin, Alana Cianciulli, Yuval Barak-Corren, Csaba Pinter, Hannah Dewey, Andras Lasso, William Russell, Stephanie Colello, Ari J Gartenberg, Vlad Obsekov, Trevor Williams, Elizabeth Silvestro, Michael L O'Byrne, Andrew C Glatz, Matthew A Jolley
Author Information
  1. Mudit Gupta: Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. ORCID
  2. Silvani Amin: Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
  3. Alana Cianciulli: Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
  4. Yuval Barak-Corren: Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
  5. Csaba Pinter: EBATINCA S.L., Las Palmas, Gran Canaria, Spain.
  6. Hannah Dewey: Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. ORCID
  7. Andras Lasso: Laboratory for Percutaneous Surgery, School of Computing, Queen's University, Kingston, Canada.
  8. William Russell: Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
  9. Stephanie Colello: Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
  10. Ari J Gartenberg: Division of Pediatric Cardiology, Akron Children's Hospital, Akron, Ohio, USA. ORCID
  11. Vlad Obsekov: Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
  12. Trevor Williams: Division of Cardiology, University of Colorado School of Medicine and Children's Hospital of Colorado, Aurora, Colorado, USA.
  13. Elizabeth Silvestro: Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
  14. Michael L O'Byrne: Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. ORCID
  15. Andrew C Glatz: Division of Cardiology, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Missouri, USA.
  16. Matthew A Jolley: Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. ORCID
PMID: 40152008 DOI: 10.1002/ccd.31510

Abstract

BACKGROUND: Ductus arteriosus stenting (DAS) is used to palliate infants with ductal-dependent pulmonary blood flow (DD-PBF), however patent ductus arteriosus (PDA) anatomy can be complex and heterogenous.
AIMS: We developed custom, open-source software to model and quantify PDA anatomy.
METHODS: We retrospectively identified 33 neonates with DD-PBF with a CTA before DAS. A novel custom workflow was implemented in 3D Slicer and SlicerHeart to semi-automatically extract centerlines of the course of the PDA and surrounding vessels. 3D ductal length, diameter, curvature and tortuosity were automatically calculated (3D automatic) and compared to manually adjusted 3D measurements (3D semi-automatic), and manual measurements of PDA dimensions in 2D projectional angiograms before and after stent angioplasty.
RESULTS: Ductal anatomy was successfully modeled and quantified in all subjects. 3D automatic and semi-automatic measurements of straight-line aortic to pulmonary artery length were not significantly different than 2D measurements. Semi-automatic 3D measurements were similar to 2D measurements of the total length. Minimum and maximum ductal diameters were not significantly different by 3D automatic and 2D measurements, however semi-automatic 3D diameters were significantly larger. Inter-reader reliability of ductal length and diameter was higher with manual adjustment of 3D centerlines compared to standard measurement of 2D angiograms. These differences were consistent across PGE doses between CTA and DAS.
CONCLUSIONS: Automatic PDA modeling is feasible and efficient, enabling reproducible quantification of ductal anatomy for procedural planning of DAS in patients with DD-PBF. Further development is needed as well as investigation of whether 3D modeling-derived measurements influence procedural duration or outcome.

Keywords

3D modeling CT angiography PDA stent congenital heart disease quantification

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Grants

  1. /This study was supported by NIH R01HL153166, an Additional Ventures Expansion Award, Additional Ventures Single Ventricle Research Fund, The Topolewski Endowed Chair at the Children's Hospital of Philadelphia, T32 HL0097915, CHOP Cardiac Center Research Grant.
Journal Article
Article has an altmetric score of 5

Word Cloud

Created with Highcharts 10.0.03DmeasurementsPDA2DDASanatomyductallengthDD-PBFautomaticsemi-automaticsignificantlyarteriosuspulmonaryhowevercustomCTAcenterlinesdiametercomparedmanualangiogramsstentDuctaldifferentdiametersmodelingquantificationproceduralBACKGROUND:Ductusstentingusedpalliateinfantsductal-dependentbloodflowpatentductuscancomplexheterogenousAIMS:developedopen-sourcesoftwaremodelquantifyMETHODS:retrospectivelyidentified33neonatesnovelworkflowimplementedSlicerSlicerHeartsemi-automaticallyextractcoursesurroundingvesselscurvaturetortuosityautomaticallycalculatedmanuallyadjusteddimensionsprojectionalangioplastyRESULTS:successfullymodeledquantifiedsubjectsstraight-lineaorticarterySemi-automaticsimilartotalMinimummaximumlargerInter-readerreliabilityhigheradjustmentstandardmeasurementdifferencesconsistentacrossPGEdosesCONCLUSIONS:Automaticfeasibleefficientenablingreproducibleplanningpatientsdevelopmentneededwellinvestigationwhethermodeling-derivedinfluencedurationoutcomeQuantitativeAnalysisAnatomyInformPlanningArteriosusStentingCTangiographycongenitalheartdisease

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