Abstract
Abstract 379: Three‐Dimensional Volumetric Assessment Improves Growth Detection In Unruptured Intracranial Aneurysms
Stroke: vascular and interventional neurology, Vol.5(S1)
11/01/2025
DOI: 10.1161/svi270000_379
PMCID: PMC12850079
Abstract
Introduction/Purpose Monitoring the growth of unruptured intracranial aneurysms (UIAs) is critical for guiding treatment, but conventional two‐dimensional size‐based monitoring may miss subtle growth and inaccurately estimate rupture risk. Evidence suggests aneurysm volume may offer more consistent and sensitive assessment of morphological changes. This study aims to evaluate the effectiveness of three‐dimensional volumetric analysis in detecting significant aneurysm growth compared to standard size‐based assessment during routine clinical management, and identify factors associated with growth using volumetric criteria. Materials/Methods Patients who underwent UIA surveillance at a single center between January 2024 and January 2025 were retrospectively included. Inclusion required baseline and follow‐up imaging (CTA, CE‐MRA, or TOF‐MRA) at least 4 months apart. Treated, ruptured, or thrombosed aneurysms were excluded. Aneurysm size was obtained from clinical records. Volumetric analysis was performed using 3D Slicer, with manual segmentation of aneurysms and ipsilateral parent arteries at both timepoints. Registration errors and imaging differences were accounted for by measuring changes in parent artery volume. Enclosed aneurysm volume was calculated from surface meshes, and inter‐observer consistency was evaluated in a subset of 25 aneurysms. Volumetric growth was defined as change exceeding a logistic mixed model‐derived threshold; 2D growth was defined as increase in maximal diameter ≥1 mm. Subgroup analyses were performed by baseline aneurysm size. Logistic regression was performed to identify predictors of volumetric growth. Results Ninety‐eight patients (70 female; median age 66.5 (IQR: 57‐75) years) with 123 UIAs were included in the study. Twenty‐four aneurysms (20%) demonstrated significant volumetric growth (≥50%). Volumetric growth detected all 2D‐defined growing aneurysms (n = 8) and identified an additional 16 aneurysms missed by 2D criteria, which were predominantly older females. These missed aneurysms showed significantly lower 2D growth (median size change: 4% vs 38%). Logistic regression identified follow‐up time (aOR 1.20, 95% CI 1.03‐1.42, p = 0.021) and high‐risk location (aOR 6.96, 95% CI 1.93‐33.6, p = 0.006) as independent predictors of volumetric growth, with an AUC of 0.79. Conclusion Volumetric analysis detects aneurysm growth more effectively than size‐based measurements, identifying a substantial proportion (16/24) of aneurysms missed by size‐based monitoring. Growth was associated with longer follow‐up and high‐risk locations, highlighting the potential of volumetric assessment to improve surveillance and guide clinical decision‐making in UIAs.
Details
- Title: Subtitle
- Abstract 379: Three‐Dimensional Volumetric Assessment Improves Growth Detection In Unruptured Intracranial Aneurysms
- Creators
- N Shenoy - University of IowaE Sagues - University of IowaP. R Mekala - University of IowaK. T Shoukih - University of IowaL DiazD CifuentesR CalleL Wendt - University of IowaI Salinas - University of Iowa, NeurologyP Martinez - University of Iowa, NeurologyA Gudino - University of IowaE. A Samaniego - University of Iowa
- Resource Type
- Abstract
- Publication Details
- Stroke: vascular and interventional neurology, Vol.5(S1)
- DOI
- 10.1161/svi270000_379
- PMCID
- PMC12850079
- ISSN
- 2694-5746
- eISSN
- 2694-5746
- Publisher
- Wiley Subscription Services, Inc
- Language
- English
- Date published
- 11/01/2025
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Surgery; Neurosurgery
- Record Identifier
- 9985089029702771
Metrics
5 Record Views