Room 201
Purpose: Single-plane image acquisitions of complex aneurysms lack in clear visual representation of the vessel geometry and flow detail. Implementation of a simultaneous biplane high-speed angiographic (HSA) system addresses this limitation, where multiple projection views enable improved assessment of complex flow details. Further, new larger-FOV photon-counting detectors (PCD’s) can encompass a wider range of arterial geometries.
Methods: Two high-speed photon-counting detectors (Aries by Varex, 7.5 x 5 cm FOV) were used to provide 1000-fps image sequences of a flow tracer within several complex patient-specific internal carotid artery aneurysm models. Automated iodine contrast injections were used to visualize fluid dynamics in each 3D-printed model in both the frontal and lateral planes over a sequence duration of a few-hundred milliseconds. Simultaneous orthogonal radiographic exposures were performed with equivalent technique parameters and RQA5 spectra. One Aries detector was mounted on the floor-mounted C-arm using a swinging mechanical arm, allowing for easy positioning in the frontal plane. The second detector was positioned orthogonal to the first detector on the table to capture flow patterns in the lateral view.
Results: Simultaneous data acquisition from two orthogonal planes allowed for improved visualization of complex aneurysm geometries and multiple flow streamlines. Qualitative assessment of vortex flows at depth, location of inflow jet impingement on the aneurysm dome, and flow through out-of-plane vessels can be performed. Quantitative analysis of flow streamlines can be compared in each plane, recovering details that may be obscured with a standard single-projection view.
Conclusion: The use of two larger-FOV PCD’s expands the limitations of single-projection imaging for detailed flow analysis in a range of arterial geometries. The ability to recover fluid dynamics at depth enables more-accurate analysis of 3D flow streamlines, laying the foundation for volumetric flow visualization and quantification.
Funding Support, Disclosures, and Conflict of Interest: This research was supported by NIH Grant R01EB030092, and in part by Canon Medical Systems Inc.