Abdominal aortic aneurysms: Virtual imaging and analysis through a remote web server

The study describes theapplication of a web-based softwarein the planning of the endovasculartreatment of abdominal aorticaneurysms (AAA). The softwarehas been developed in the frameworkof a 2-year research projectcalled Aneurysm QUAntificationThrough an Internet CollaborativeSystem (AQUATICS); it allows tomanage remotely Virtual RealityModeling Language (VRML) modelsof the abdominal aorta, derived frommultirow computed tomographyangiography (CTA) data sets, and toobtain measurements of diameters,angles and centerline lengths. Totest the reliability of measurements,two radiologists performed a detailedanalysis of multiple 3D modelsgenerated from a synthetic phantom,mimicking an AAA. The systemwas tested on 30 patients with AAA;CTA data sets were mailed and thetime required for segmentation andmeasurement were collected foreach case. The Bland-Altman plotanalysis showed that the mean intraandinter-observer differences inmeasures on phantoms were clinicallyacceptable. The mean timerequired for segmentation was 1 h(range 45–120 min). The mean timerequired for measurements on theweb was 7 min (range 4–11 min).The AQUATICS web server mayprovide a rapid, standardized andaccurate tool for the evaluation ofAAA prior to the endovascular treatment.