Gene Expression Signature As A Diagnostic Test For Thoracic Aortic Aneurysms: A Validation Study

Thoracic aortic aneurysms (TAAs) are clinically-silent diseases that predispose individuals to life-threatening aortic dissection or rupture. If detected early, TAAs can be safely treated with elective surgery. Therefore, there is a great clinical need in screening for TAAs. However, no reliable screening programs exist, and radiographic imaging is too costly and harmful for screening entire at-risk populations. We hypothesize that a novel diagnostic blood test based on the gene-expression profiles of a previously-identified panel of 41 genes (a RNA signature) is greater than 70% sensitive in detecting TAAs. Using RNA extracted from peripheral blood cells of 40 individuals (24 TAA patients and 16 spousal controls), we performed real-time PCR using customized TaqMan Array Cards to analyze the relative expression levels of this panel of genes. A 10-fold cross-validation study based on these expression levels was used to predict whether each sample belonged to a TAA patient or a spousal control. When compared with each sample\u27s true clinical status, this RNA signature-based prediction model was 83% accurate, with a sensitivity of 88% and a specificity of 75%. Furthermore, the expression levels of the individual genes were largely consistent with their expression levels from a previous study of this RNA signature (r2 = 0.75 for TAA patient samples, and r2 = 0.73 for spousal control samples), supporting the reproducibility of this test. Altogether, these findings demonstrate that gene-expression profiling is an accurate, sensitive, and reliable method for detecting TAAs. If utilized as a clinical screening test, this RNA signature has the potential to detect silent TAAs, leading to earlier diagnosis and reduced mortality of this dangerous condition

Precise Tracking and Initial Segmentation of Abdominal Aortic Aneurysm

[[abstract]]In this paper we propose a mean-shift based technique for a precise tracking and segmentation of abdominal aortic aneurysm (AAA) from computed tomography (CT) angiography images. The proposed method applies median filter on the gradient of ray-length and linear interpolation for denoising. The segmentation result can be used for measurement of aortic shape and dimensions. Knowledge of aortic shape and size is very important for selection of appropriate stent graft device for treatment of AAA. Comparing to conventional approaches, our method is very efficient and can save a lot of manual labors.[[conferencetype]]國際[[conferencedate]]20131102~20131104[[booktype]]電子版[[iscallforpapers]]Y[[conferencelocation]]Aizu-Wakamatsu, Japa

3D Imaging for Planning of Minimally Invasive Surgical Procedures

Novel minimally invasive surgeries are used for treating cardiovascular diseases and are performed under 2D fluoroscopic guidance with a C-arm system. 3D multidetector row computed tomography (MDCT) images are routinely used for preprocedural planning and postprocedural follow-up. For preprocedural planning, the ability to integrate the MDCT with fluoroscopic images for intraprocedural guidance is of clinical interest. Registration may be facilitated by rotating the C-arm to acquire 3D C-arm CT images. This dissertation describes the development of optimal scan and contrast parameters for C-arm CT in 6 swine. A 5-s ungated C-arm CT acquisition during rapid ventricular pacing with aortic root injection using minimal contrast (36 mL), producing high attenuation (1226), few artifacts (2.0), and measurements similar to those from MDCT (p\u3e0.05) was determined optimal. 3D MDCT and C-arm CT images were registered to overlay the aortic structures from MDCT onto fluoroscopic images for guidance in placing the prosthesis. This work also describes the development of a methodology to develop power equation (R2\u3e0.998) for estimating dose with C-arm CT based on applied tube voltage. Application in 10 patients yielded 5.48┬▒177 2.02 mGy indicating minimal radiation burden. For postprocedural follow-up, combinations of non-contrast, arterial, venous single energy CT (SECT) scans are used to monitor patients at multiple time intervals resulting in high cumulative radiation dose. Employing a single dual-energy CT (DECT) scan to replace two SECT scans can reduce dose. This work focuses on evaluating the feasibility of DECT imaging in the arterial phase. The replacement of non-contrast and arterial SECT acquisitions with one arterial DECT acquisition in 30 patients allowed generation of virtual non-contrast (VNC) images with 31 dose savings. Aortic luminal attenuation in VNC (32┬▒177 2 HU) was similar to true non-contrast images (35┬▒177 4 HU) indicating presence of unattenuated blood. To improve discrimination between c

Optimization of CT scanning protocol of Type B aortic dissection follow-up through 3D printed model

This research aims to develop and evaluate a human tissue-like material 3D printed model used as a phantom in determining optimized scanning parameters to reduce the radiation dose for Type B aortic dissection patients after thoracic endovascular aortic repair. The results show that radiation risk for follow-up Type B aortic dissection patients can be potentially reduced. Further, the value of using 3D printed model in studying CT scanning protocols was further validated

3D Imaging for Planning of Minimally Invasive Surgical Procedures

Novel minimally invasive surgeries are used for treating cardiovascular diseases and are performed under 2D fluoroscopic guidance with a C-arm system. 3D multidetector row computed tomography (MDCT) images are routinely used for preprocedural planning and postprocedural follow-up. For preprocedural planning, the ability to integrate the MDCT with fluoroscopic images for intraprocedural guidance is of clinical interest. Registration may be facilitated by rotating the C-arm to acquire 3D C-arm CT images. This dissertation describes the development of optimal scan and contrast parameters for C-arm CT in 6 swine. A 5-s ungated C-arm CT acquisition during rapid ventricular pacing with aortic root injection using minimal contrast (36 mL), producing high attenuation (1226), few artifacts (2.0), and measurements similar to those from MDCT (p\u3e0.05) was determined optimal. 3D MDCT and C-arm CT images were registered to overlay the aortic structures from MDCT onto fluoroscopic images for guidance in placing the prosthesis. This work also describes the development of a methodology to develop power equation (R2\u3e0.998) for estimating dose with C-arm CT based on applied tube voltage. Application in 10 patients yielded 5.48┬▒177 2.02 mGy indicating minimal radiation burden. For postprocedural follow-up, combinations of non-contrast, arterial, venous single energy CT (SECT) scans are used to monitor patients at multiple time intervals resulting in high cumulative radiation dose. Employing a single dual-energy CT (DECT) scan to replace two SECT scans can reduce dose. This work focuses on evaluating the feasibility of DECT imaging in the arterial phase. The replacement of non-contrast and arterial SECT acquisitions with one arterial DECT acquisition in 30 patients allowed generation of virtual non-contrast (VNC) images with 31 dose savings. Aortic luminal attenuation in VNC (32┬▒177 2 HU) was similar to true non-contrast images (35┬▒177 4 HU) indicating presence of unattenuated blood. To improve discrimination between c

Computational estimation of haemodynamics and tissue stresses in abdominal aortic aneurysms

'o e Abdominal aortic aneurysm is a vascular disease involving a focal dilation of the aorta. The exact cause is unknown but possibilities include infection and weakening of the connective tissue. Risk factors include a history of atherosclerosis, current smoking and a close relative with the disease. Although abdominal aortic aneurysm can affect anyone, it is most often seen in older men, and may be present in up to 5.9 % of the population aged 80 years. Biomechanical factors such as tissue stresses and shear stresses have been shown to play a part in aneurysm progression, although the specific mechanisms are still to be determined. The growth rate of the abdominal aortic aneurysm has been found to correlate with the peak stress in the aneurysm wall and the blood flow is thought to influence disease development. In order to resolve the connections between biology and biomechanics, accurate estimations of the forces involved are required. The first part of this thesis assesses the use of computational fluid dynamics for modelling haemodynamics in abdominal aortic aneurysms. Boundary conditions from the literature o