Preliminary intraobserver and interobserver variability in wall stress and rupture risk assessment of abdominal aortic aneurysms using a semiautomatic.

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Preliminary intraobserver and interobserver variability in wall stress and rupture risk assessment of abdominal aortic aneurysms using a semiautomatic finite element model Arno Teutelink, MD, Ernst Cancrinus, MD, Danyel van de Heuvel, MD, Frans Moll, MD, PhD, Jean-Paul de Vries, MD, PhD Journal of Vascular Surgery Volume 55, Issue 2, Pages 326-330 (February 2012) DOI: 10.1016/j.jvs.2011.08.012 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 In this example of semiautomated segmentation of the aneurysm and finite element analysis, the surface is represented by quadrilateral elements. Color-coding is used to indicate areas of low (blue) or high wall stress (red). Journal of Vascular Surgery 2012 55, 326-330DOI: (10.1016/j.jvs.2011.08.012) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 A, After the semiautomated segmentation of the aneurysm, the deformable model outruns the outer boundary at certain spots, such as the small interface with outer structures like the small bowel. The yellow line indicates the luminal surface and the blue line indicates the outer surface of the aneurysm. B, Image reconstruction can be performed by blocking the model using a pencil stripe and by redefinition of the boundary points. After this image reconstruction, the segmentation will follow the outer boundaries correctly. Journal of Vascular Surgery 2012 55, 326-330DOI: (10.1016/j.jvs.2011.08.012) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 3 Bland-Altman analysis: intraobserver variability of the von Mises stress for observers (A) I, (B) II, and (C) III. The mean of the measurements is plotted along the x axis, and the difference between the measurements of the observer is plotted along the y axis. The solid line indicates the mean difference, and the dotted lines indicate 1.96 standard deviations above and below the mean difference. Journal of Vascular Surgery 2012 55, 326-330DOI: (10.1016/j.jvs.2011.08.012) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 4 Bland-Altman analysis: intraobserver variability of the peak wall stress rupture risk (PWRR) for observers (A) I, (B) II, and (C) III. The mean of the measurements is plotted along the x axis, and the difference between the measurements of the observer is plotted along the y axis. The solid line indicates the mean difference, and the dotted lines indicate 1.96 standard deviations above and below the mean difference. Journal of Vascular Surgery 2012 55, 326-330DOI: (10.1016/j.jvs.2011.08.012) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 5 Bland-Altman analysis: interobserver variability of the von Mises stress. The mean of the measurements is plotted along the x axis, and the difference between the measurements of the observers is plotted along the y axis. The solid line indicates the mean difference, and the dotted lines indicate 1.96 standard deviations above and below the mean difference. Journal of Vascular Surgery 2012 55, 326-330DOI: (10.1016/j.jvs.2011.08.012) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 6 Bland-Altman analysis: interobserver variability of the peak wall stress rupture risk (PWRR). The mean of the measurements is plotted along the x axis, and the difference between the measurements of the observers is plotted along the y axis. The solid line indicates the mean difference, and the dotted lines indicate 1.96 standard deviations above and below the mean difference. Journal of Vascular Surgery 2012 55, 326-330DOI: (10.1016/j.jvs.2011.08.012) Copyright © 2012 Society for Vascular Surgery Terms and Conditions