用几何神经网络预测腹主动脉瘤局部生长,提升个性化监测精度。
Geometric deep learning for local growth prediction on abdominal aortic aneurysm surfaces
- 基于血管表面的多物理特征,使用SE(3)对称Transformer建模
- 预测误差中位数仅1.18毫米,两年内手术可行性预测准确率达93%
- 保留解剖结构完整,适合临床个性化随访场景
腹主动脉瘤(AAA)是腹主动脉的进行性局部扩张,破裂后生存率仅20%。当前临床指南建议男性最大直径超过55毫米、女性超过50毫米时行择期手术。未达标准者需定期监测,但监测间隔仅依据最大直径,忽略三维形状与生长的复杂关系,可能导致标准化方案不适用。个性化生长预测可优化随访策略。本文提出一种SE(3)-对称Transformer模型,直接在富含局部多物理特征的血管表面进行生长预测。相比其他参数化方法,该表示保持了解剖结构和几何保真度。模型基于113次来自24名患者的不规则时间点CTA扫描数据训练。训练后,模型对下一次扫描的直径预测中位误差为1.18毫米。进一步验证显示,模型对患者两年内是否达到手术标准的预测准确率达0.93。外部验证集包含7名患者共25次CTA扫描,结果表明从血管表面进行局部方向性生长预测具有可行性,有望推动个性化随访策略发展。
原文摘要 · Abstract (English)
Abdominal aortic aneurysms (AAAs) are progressive focal dilatations of the abdominal aorta. AAAs may rupture, with a survival rate of only 20\%. Current clinical guidelines recommend elective surgical repair when the maximum AAA diameter exceeds 55 mm in men or 50 mm in women. Patients that do not meet these criteria are periodically monitored, with surveillance intervals based on the maximum AAA diameter. However, this diameter does not take into account the complex relation between the 3D AAA shape and its growth, making standardized intervals potentially unfit. Personalized AAA growth predictions could improve monitoring strategies. We propose to use an SE(3)-symmetric transformer model to predict AAA growth directly on the vascular model surface enriched with local, multi-physical features. In contrast to other works which have parameterized the AAA shape, this representation preserves the vascular surface's anatomical structure and geometric fidelity. We train our model using a longitudinal dataset of 113 computed tomography angiography (CTA) scans of 24 AAA patients at irregularly sampled intervals. After training, our model predicts AAA growth to the next scan moment with a median diameter error of 1.18 mm. We further demonstrate our model's utility to identify whether a patient will become eligible for elective repair within two years (acc = 0.93). Finally, we evaluate our model's generalization on an external validation set consisting of 25 CTAs from 7 AAA patients from a different hospital. Our results show that local directional AAA growth prediction from the vascular surface is feasible and may contribute to personalized surveillance strategies.
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