Iris N. Vos

Kimberley M. Timmins, Maarten J. Kamphuis, Iris N. Vos et al.

The growth of unruptured intracranial aneurysms (UIAs) is a predictor of rupture. Therefore, for further imaging surveillance and treatment planning, it is important to be able to predict if an UIA is likely to grow based on an initial baseline Time-of-Flight MRA (TOF-MRA). It is known that the size and shape of UIAs are predictors of aneurysm growth and/or rupture. We perform a feasibility study of using a mesh convolutional neural network for future UIA growth prediction from baseline TOF-MRAs. We include 151 TOF-MRAs, with 169 UIAs where 49 UIAs were classified as growing and 120 as stable, based on the clinical definition of growth (>1 mm increase in size in follow-up scan). UIAs were segmented from TOF-MRAs and meshes were automatically generated. We investigate the input of both UIA mesh only and region-of-interest (ROI) meshes including UIA and surrounding parent vessels. We develop a classification model to predict UIAs that will grow or remain stable. The model consisted of a mesh convolutional neural network including additional novel input edge features of shape index and curvedness which describe the surface topology. It was investigated if input edge mid-point co-ordinates influenced the model performance. The model with highest AUC (63.8%) for growth prediction was using UIA meshes with input edge mid-point co-ordinate features (average F1 score = 62.3%, accuracy = 66.9%, sensitivity = 57.3%, specificity = 70.8%). We present a future UIA growth prediction model based on a mesh convolutional neural network with promising results.

Kaiyuan Yang, Fabio Musio, Yihui Ma et al.

The Circle of Willis (CoW) is an important network of arteries connecting major circulations of the brain. Its vascular architecture is believed to affect the risk, severity, and clinical outcome of serious neurovascular diseases. However, characterizing the highly variable CoW anatomy is still a manual and time-consuming expert task. The CoW is usually imaged by two non-invasive angiographic imaging modalities, magnetic resonance angiography (MRA) and computed tomography angiography (CTA), but there exist limited datasets with annotations on CoW anatomy, especially for CTA. Therefore, we organized the TopCoW challenge with the release of an annotated CoW dataset. The TopCoW dataset is the first public dataset with voxel-level annotations for 13 CoW vessel components, enabled by virtual reality technology. It is also the first large dataset using 200 pairs of MRA and CTA from the same patients. As part of the benchmark, we invited submissions worldwide and attracted over 250 registered participants from six continents. The submissions were evaluated on both internal and external test datasets of 226 scans from over five centers. The top performing teams achieved over 90% Dice scores at segmenting the CoW components, over 80% F1 scores at detecting key CoW components, and over 70% balanced accuracy at classifying CoW variants for nearly all test sets. The best algorithms also showed clinical potential in classifying fetal-type posterior cerebral artery and locating aneurysms with CoW anatomy. TopCoW demonstrated the utility and versatility of CoW segmentation algorithms for a wide range of downstream clinical applications with explainability. The annotated datasets and best performing algorithms have been released as public Zenodo records to foster further methodological development and clinical tool building.