{"id":2098,"date":"2023-05-24T08:09:43","date_gmt":"2023-05-24T06:09:43","guid":{"rendered":"https:\/\/risc.web-email.at\/fachbeitrag-automatische-bild-segmentierung-der-bauchaorta-und-stent-grafts-mittels-kuenstlicher-intelligenz\/"},"modified":"2025-06-02T15:09:30","modified_gmt":"2025-06-02T13:09:30","slug":"technical-article-automatic-image-segmentation-of-the-abdominal-aorta-and-stent-grafts-using-artificial-intelligence","status":"publish","type":"publication","link":"https:\/\/risc.web-email.at\/en\/technicalarticles\/technical-article-automatic-image-segmentation-of-the-abdominal-aorta-and-stent-grafts-using-artificial-intelligence\/","title":{"rendered":"Automatic image segmentation of the abdominal aorta and stent grafts using artificial intelligence"},"content":{"rendered":"\n<h2 class=\"wp-block-heading is-style-v2-telegrafico\">Today&#8217;s technology for tomorrow&#8217;s medicine<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">by Bertram Sabrowsky-Hirsch, MSc und DI Dr. Stefan Thumfart<\/h3>\n\n\n<div class=\"wp-block-group-container alignfull \">\n<div class=\"wp-block-group alignfull is-layout-constrained wp-block-group-is-layout-constrained\">\n<p><em>Aortic aneurysms are a critical vascular disease and are associated with thousands of deaths each year. The most common procedure performed is endovascular aortic repair (EVAR), in which a stent-graft prosthesis is placed in the abdominal aorta to prevent rupture. However, the procedure is associated with a high complication rate and requires regular follow-up examinations. These can now be improved by means of segmentation and calculation of measures.<\/em><br><br><\/p>\n\n\n\n<div style=\"height:100px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"wp-block-media-text has-media-on-the-right is-stacked-on-mobile is-vertically-aligned-center\"><div class=\"wp-block-media-text__content\">\n<p><strong>Table of contents<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Reducing complications of endovascular aortic repair<\/li>\n\n\n\n<li>Innovative solution: Centreline-based method<\/li>\n\n\n\n<li>References<\/li>\n\n\n\n<li>Authors<\/li>\n<\/ul>\n<\/div><figure class=\"wp-block-media-text__media\"><img decoding=\"async\" width=\"1024\" height=\"673\" src=\"https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/iStock-182670645-1024x673.jpg\" alt=\"Medicine and Technology\" class=\"wp-image-2031 size-full\" srcset=\"https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/iStock-182670645-1024x673.jpg 1024w, https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/iStock-182670645-300x197.jpg 300w, https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/iStock-182670645-768x505.jpg 768w, https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/iStock-182670645-1536x1010.jpg 1536w, https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/iStock-182670645.jpg 1920w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure><\/div>\n<\/div>\n<\/div>\n\n<div class=\"wp-block-group-container alignfull \">\n<div class=\"wp-block-group alignfull is-layout-constrained wp-block-group-is-layout-constrained\">\n<h3 class=\"wp-block-heading\">Reducing complications of endovascular aortic repair<\/h3>\n\n\n\n<p>An abdominal aortic aneurysm is often discovered by chance, rarely manifesting itself with unclear symptoms such as abdominal pain or radiating pain in the back or groin. The frequency of an abdominal aneurysm in the population is around 40 per 100,000 people, mainly men over the age of 65. [1].<\/p>\n\n\n\n<p>Once the diagnosis has been made, a decision must be made together with the doctor as to which treatment is appropriate. Currently, an &#8220;endovascular aortic repair&#8221; (EVAR) is chosen in 3\/4 of cases, as it is less stressful than surgery. In EVAR, a stent-graft (Fig. 1) is inserted via a catheter in such a way that the aneurysm wall is relieved and thus the risk of rupture is eliminated. A disadvantage of the method, however, is that ongoing follow-up examinations are necessary, as complications (e.g. so-called endo-leaks) can occur.<\/p>\n\n\n\n<p>In addition to the skills of the doctor and a high-quality stent-graft, the vascular structure is also important for the success of EVAR. Ideally, a CT-A scan (computer tomography &#8211; angiography, a 3D imaging technique that uses contrast to highlight the blood lumen) prior to the procedure could be used to decide how likely a complication is to occur or how often a follow-up examination is necessary. This is based on the automatic extraction and characterisation of the blood vessel and stent-graft from these scans.<\/p>\n\n\n\n<p>The <strong>automatic extraction of the aorta and stent-graft<\/strong> must fulfil the following characteristics:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>fast runtime for clinical application on consumer hardware,<\/li>\n\n\n\n<li>robust for different stent-graft types and vessel topologies,<\/li>\n\n\n\n<li>High resolution for exact detection of the (fine) stent-graft lattice structures.<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img decoding=\"async\" width=\"962\" height=\"1024\" sizes=\"(max-width: 962px) 100vw, 962px\" src=\"https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/2021-02-03-Automatische-Bild-Segmentierung_Abb1.jpg\" alt=\"Stent. Graft\" class=\"wp-image-2033\" srcset=\"https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/2021-02-03-Automatische-Bild-Segmentierung_Abb1.jpg 962w, https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/2021-02-03-Automatische-Bild-Segmentierung_Abb1-282x300.jpg 282w, https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/2021-02-03-Automatische-Bild-Segmentierung_Abb1-768x817.jpg 768w\" \/><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img decoding=\"async\" width=\"936\" height=\"476\" sizes=\"(max-width: 936px) 100vw, 936px\" src=\"https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/2021-02-03-Automatische-Bild-Segmentierung.Abb2_.png\" alt=\"Aorta Segmentation\" class=\"wp-image-2035\" srcset=\"https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/2021-02-03-Automatische-Bild-Segmentierung.Abb2_.png 936w, https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/2021-02-03-Automatische-Bild-Segmentierung.Abb2_-300x153.png 300w, https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/2021-02-03-Automatische-Bild-Segmentierung.Abb2_-768x391.png 768w\" \/><\/figure>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\">\n<p><strong>Fig.1<\/strong>&nbsp;Stent.Graft<\/p>\n\n\n\n<p>Source:&nbsp;<a href=\"https:\/\/sml.snl.no\/stent\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/sml.snl.no\/stent<\/a><\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\">\n<p><strong>Fig. 2<\/strong>&nbsp;Segmentation of aorta and stent graft in two phases. Top: Extraction of the centreline from a low-resolution scan. Bottom: Segmentation from high resolution scan patches. These patches are positioned using the centreline information.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"wp-block-group-container alignfull \">\n<div class=\"wp-block-group alignfull is-layout-constrained wp-block-group-is-layout-constrained\">\n<h3 class=\"wp-block-heading\">Innovative solution: Centreline-based method<\/h3>\n\n\n\n<p>The solution developed by RISC Software GmbH [3, 4] is based on current methods for medical segmentation using Deep Learning. So-called U-nets [5] have become established as the basic model architecture in this field. Researchers have developed a two-phase approach (Fig. 2). First, the centrelines of the aorta are determined using a low-resolution data set. This can also be done in one step on consumer graphics cards with less texture memory. Based on these media lines, smaller (high-resolution) patches are extracted from the scan in phase 2 and used for training or prediction. In this way, even fine details (stent-graft grids) can be segmented reliably. The method was evaluated for 76 CT-A scans (36 patients). The average (median) DICE score is 0.969 (blood lumen) and 0.879 (stent-graft).<\/p>\n\n\n\n<p>The centreline-based method can be trained and executed on a consumer graphics card (NVIDIA GTX 1080 TI). Compared to the state-of-the-art segmentation framework nnU-Net [6], the prediction time for a 3D scan could be reduced from an average of 10min 24sec to 1min 54sec &#8211; with the same accuracy. In total, scans with five different stent-graft types were successfully segmented.<\/p>\n\n\n\n<p>As part of the research project EndoPredictor [2], RISC Software GmbH together with MATTES Medical Imaging and Kepler University Hospital MCIII investigated how well complications can be predicted. A scientific publication of the results is currently being prepared.<\/p>\n<\/div>\n<\/div>\n\n<div class=\"wp-block-group-container alignfull \">\n<div class=\"wp-block-group alignfull is-layout-constrained wp-block-group-is-layout-constrained\">\n<h3 class=\"wp-block-heading\">References<\/h3>\n\n\n\n<p>[1]&nbsp;https:\/\/www.gesundheit.gv.at\/krankheiten\/herz-kreislauf\/arterien\/aneurysma-aorta<\/p>\n\n\n\n<p>[2]&nbsp;<a href=\"https:\/\/risc-software.at\/endopredictor\/\" target=\"_blank\" rel=\"noopener\">https:\/\/risc-software.at\/endopredictor\/<\/a><\/p>\n\n\n\n<p>[3] Sabrowsky-Hirsch, Bertram, Stefan Thumfart, Richard Hofer, Wolfgang Fenz, Pierre Schmit, and Franz Fellner. \u201cA Centerline-Guided Approach for Aorta and Stent-Graft Segmentation.\u201d In Proceedings of the Joint Austrian Computer Vision and Robotics Workshop 2020, 102\u20137. Verlag der TU Graz, 2020.&nbsp;<a href=\"https:\/\/doi.org\/10.3217\/978-3-85125-752-6-24\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.3217\/978-3-85125-752-6-24<\/a>.<\/p>\n\n\n\n<p>[4] Sabrowsky-Hirsch, Bertram, Stefan Thumfart, Wolfgang Fenz, and Richard Hofer.&nbsp;\u201cAutomatic Segmentation of the Abdominal Aorta and Stent-Grafts.\u201d Journal of Image and Graphics, accepted 2021.<\/p>\n\n\n\n<p>[5] Ronneberger, Olaf, Philipp Fischer, and Thomas Brox. \u201cU-Net: Convolutional Networks for Biomedical Image Segmentation.\u201d In Medical Image Computing and Computer-Assisted Intervention \u2013 MICCAI 2015, 234\u201341. Lecture Notes in Computer Science. Springer, Cham, 2015.&nbsp;<a href=\"https:\/\/doi.org\/10.1007\/978-3-319-24574-4_28\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1007\/978-3-319-24574-4_28<\/a>.<\/p>\n\n\n\n<p>[6] Isensee, Fabian, Paul F. Jaeger, Simon A. A. Kohl, Jens Petersen, and Klaus H. Maier-Hein.&nbsp;\u201cNnU-Net: A Self-Configuring Method for Deep Learning-Based Biomedical Image Segmentation.\u201d&nbsp;Nature Methods, December 7, 2020, 1\u20139.&nbsp;<a href=\"https:\/\/doi.org\/10.1038\/s41592-020-01008-z\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1038\/s41592-020-01008-z<\/a>.<\/p>\n<\/div>\n<\/div>\n\n<div class=\"wp-block-group-container alignfull \">\n<div class=\"wp-block-group alignfull is-layout-constrained wp-block-group-is-layout-constrained\">\n<h3 class=\"wp-block-heading\">Authors<\/h3>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div class=\"contact-person\">\n      <picture>\n      \n      \n      \n      \n      <img decoding=\"async\" data-aos=\"fade-zoom-in\"\n           data-aos-offset=\"0\" class=\"w-full\" width=\"212\" height=\"293\"\n           src=\"https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/bsabrows1-removebg-preview.png\"\n           alt=\"\">\n    <\/picture>\n    \n\n<h5 class=\"wp-block-heading\">Bertram Sabrowsky-Hirsch, MSc<\/h5>\n\n\n\n<p>Researcher &amp; Developer Medical Informatics<\/p>\n\n  <\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div class=\"contact-person\">\n      <picture>\n      \n      \n      \n      \n      <img decoding=\"async\" data-aos=\"fade-zoom-in\"\n           data-aos-offset=\"0\" class=\"w-full\" width=\"212\" height=\"293\"\n           src=\"https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/sthumfar1-removebg-preview.png\"\n           alt=\"\">\n    <\/picture>\n    \n\n<h5 class=\"wp-block-heading\">DI Dr. Stefan Thumfart<\/h5>\n\n\n\n<p>Project Manager &amp; Senior Researcher<\/p>\n\n  <\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n<div class=\"wp-block-group-container alignfull \">\n<div class=\"wp-block-group is-layout-constrained wp-block-group-is-layout-constrained\">\n<h3 class=\"wp-block-heading\">Contact<\/h3>\n\n\n\n<div class=\"wp-block-contact-form-7-contact-form-selector\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f663-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"663\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/publication\/2098#wpcf7-f663-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"663\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f663-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<div class=\"form-row\">\n\t<div class=\"form-input\">\n\t\t<p><label class=\"sr-only\" for=\"your-name\">Your name <\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"your-name\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Name\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"form-input\">\n\t\t<p><label class=\"sr-only\" for=\"your-email\">Your email<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" id=\"your-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"E-Mail\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"form-row\">\n\t<div class=\"form-input\">\n\t\t<p><label class=\"sr-only\" for=\"your-company\">Company <\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-company\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"your-company\" aria-invalid=\"false\" placeholder=\"Unternehmen\" value=\"\" type=\"text\" name=\"your-company\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"form-input\">\n\t\t<p><label class=\"sr-only\" for=\"your-position\">Position<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-position\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Position\" value=\"\" type=\"text\" name=\"your-position\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"form-row\">\n\t<div class=\"form-input\">\n\t\t<p><label class=\"sr-only\" for=\"your-subject\"> Subject <\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-subject\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"your-subject\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Thema\" value=\"\" type=\"text\" name=\"your-subject\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<p><span id=\"wpcf7-69de5dd2d871c-wrapper\" class=\"wpcf7-form-control-wrap phone-95-wrap\" style=\"display:none !important; 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What weight loss can I expect if I run every day? When do I need to replace the wearing parts on my machines to minimize downtimes?\n                                    <\/div>\n                                    <span class=\"inline-block mt-2 more\">mehr erfahren <span class=\"ml-1 icon-more\"><\/span><\/span>\n\n                                <\/div>\n                            <\/a>\n                                            <\/div>\n                <\/div>\n            <\/div>\n        <\/section>\n    <\/div>\n<\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Researchers at RISC Software GmbH developed a method for medical segmentation of CT-A scans of abdominal aortic aneurysms using Deep Learning.<\/p>\n","protected":false},"featured_media":2038,"template":"","publication-category":[50,77,76],"class_list":["post-2098","publication","type-publication","status-publish","has-post-thumbnail","hentry","publication-category-data-science-and-a-i","publication-category-medical-informatics","publication-category-medizin-informatik"],"acf":[],"portrait_thumb_url":"https:\/\/risc.web-email.at\/app\/uploads\/2023\/06\/2021-02-03-Fachbeitrag-Bild-Segmentierung-360x214.jpg","_links":{"self":[{"href":"https:\/\/risc.web-email.at\/en\/wp-json\/wp\/v2\/publication\/2098","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/risc.web-email.at\/en\/wp-json\/wp\/v2\/publication"}],"about":[{"href":"https:\/\/risc.web-email.at\/en\/wp-json\/wp\/v2\/types\/publication"}],"version-history":[{"count":9,"href":"https:\/\/risc.web-email.at\/en\/wp-json\/wp\/v2\/publication\/2098\/revisions"}],"predecessor-version":[{"id":4685,"href":"https:\/\/risc.web-email.at\/en\/wp-json\/wp\/v2\/publication\/2098\/revisions\/4685"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/risc.web-email.at\/en\/wp-json\/wp\/v2\/media\/2038"}],"wp:attachment":[{"href":"https:\/\/risc.web-email.at\/en\/wp-json\/wp\/v2\/media?parent=2098"}],"wp:term":[{"taxonomy":"publication-category","embeddable":true,"href":"https:\/\/risc.web-email.at\/en\/wp-json\/wp\/v2\/publication-category?post=2098"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}