Edinburgh Imaging

MSc projects 1516 006

A survey of the use of patient specific modelling for rupture prediction in abdominal aortic aneurysm.

  • Background: Current risk stratification for abdominal aortic aneurysm (AAA) is based on the maximum diameter criterion. A proportion of patients, however, experience rupture below the current threshold for intervention (5.5cm). Patient specific modeling using finlte element analysis (FEA) is being developed as a potential clinical tool for improving rupture risk prediction in these patients. 
  • Methods: A survey of the clinical studies regarding the use of patient specific modeling for rupture prediction was undertaken using the databases Medline and Embase, as well as Compendex and Inspec (via Engineering Village). 
  • Results: Following exclusions, 39 articles were reviewed for the project. Peak wall stress (PWS) determined by FEA demonstrated superior ability to distinguish between asymptomatic and symptomatic/ruptured AAAs over diameter criterion alone, however there was further improved efficacy when using rupture risk prediction tools based on FEA and patient specific data. Multiple clinical studies focused on refining variables used in these biornechanical models and their impact on rupture risk ( e.g. intraluminal thrombus and wall thickness). Studies that have examined intra and inter-observer agreement using semi-automated software have returned promising results. 
  • Conclusion: The reviewed studies support the utility of patient specific modeling for AAA rupture prediction over diameter alone. Future directions should involve refining models for adaptation into clinical practice, in terms of biomechanical variables, workstation applications and standardised clinical tools. 
Project type:
  • Systematic review
  • Meta-analysis
Imaging keywords:
  • Ultrasound
  • Computed tomography (CT)
  • Computer-aided diagnosis (CAD)
Application / disease keywords:
  • 15-16