We present a Cerebral Aneurysm Vortex Classification (CAVOCLA) that allows to classify blood flow in cerebral aneurysms. Medical studies assume a strong relation between the progression and rupture of aneurysms and flow patterns. To understand how flow patterns impact the vessel morphology, they are manually classified according to predefined classes. However, manual classifications are time-consuming and exhibit a high inter-observer variability. In contrast, our approach is more objective and faster than manual methods. The classification of integral lines, representing steady or unsteady blood flow, is based on a mapping of the aneurysm surface to a hemisphere by calculating polar-based coordinates. The lines are clustered and for each cluster a representative is calculated. Then, the polar-based coordinates are transformed to the representative as basis for the classification. Classes are based on the flow complexity. The classification results are presented by a detail-on-demand approach using a visual transition from the representative over an enclosing surface to the associated lines. Based on seven representative datasets, we conduct an informal interview with five domain experts to evaluate the system. They confirmed that CAVOCLA allows for a robust classification of intra-aneurysmal flow patterns. The detail-on-demand visualization enables an efficient exploration and interpretation of flow patterns.

Intracranial aneurysms are pathologic dilations of the vessel wall, which bear the risk of rupture and of fatal consequences for the patient. Since treatment may be accompanied by severe complications as well, rupture risk assessment and thus rupture risk prediction plays an important role in clinical research. In this work, we investigate the potential of morphological features for rupture risk status classification in 100 intracranial aneurysms. We propose a pipeline for morphological feature extraction and rupture status classification with subsequent feature ranking and inspection. Our classification setup involves training separate models for each aneurysm type (sidewall or bifurcation) with multiple learning algorithms. We report on the classification performance of our pipeline and examine the predictive power of each morphological parameter towards rupture status classification. Further, we identify the most important features for the best models and study their marginal prediction.

Abstract Rupture risk assessment is a key to devise patient‐specific treatment plans of cerebral aneurysms. To understand and predict the development of aneurysms and other vascular diseases over time, both hemodynamic flow patterns and their effect on the vessel surface need to be analyzed. Flow structures close to the vessel wall often correlate directly with local changes in surface parameters, such as pressure or wall shear stress. Yet, in many existing applications, the analyses of flow and surface features are either somewhat detached from one another or only globally available. Especially for the identification of specific blood flow characteristics that cause local startling parameters on the vessel surface, like elevated pressure values, an interactive analysis tool is missing. The explorative visualization of flow data is challenging due to the complexity of the underlying data. In order to find meaningful structures in the entirety of the flow, the data has to be filtered based on the respective explorative aim. In this paper, we present a combination of visualization, filtering and interaction techniques for explorative analysis of blood flow with a focus on the relation of local surface parameters and underlying flow structures. Coherent bundles of pathlines can be interactively selected based on their relation to features of the vessel wall and further refined based on their own hemodynamic features. This allows the user to interactively select and explore flow structures locally affecting a certain region on the vessel wall and therefore to understand the cause and effect relationship between these entities. Additionally, multiple selected flow structures can be compared with respect to their quantitative parameters, such as flow speed. We confirmed the usefulness of our approach by conducting an informal interview with two expert neuroradiologists and an expert in flow simulation. In addition, we recorded several insights the neuroradiologists were able to gain with the help of our tool.

The polychromatic X-ray spectrum and the energy-dependent attenuation coefficient of materials cause beam hardening artifacts in CT reconstructed volumes. These artifacts appear as cupping and streak artifacts depending on the material composition and the geometry of the imaged object. CT scanners employ projection linearization to transform polychromatic attenuation to monochromatic attenuation using a polynomial model. Polynomial coefficients are computed during calibration or using prior information such as X-ray spectrum and attenuation properties of the materials. In this paper, we are presenting a novel method to correct beam hardening artifacts by enforcing cone beam consistency conditions on the projection data. We used consistency conditions derived from Grangeat's fundamental relation between cone beam projection data and 3-D Radon transform. The optimal polynomial coefficients for artifact reduction are iteratively estimated by minimizing the inconsistency of a set of projection pairs. The results from simulated and real datasets show the visible reduction of artifacts. Our studies also demonstrate the robustness of the algorithm when the projections are perturbed with other physical measurement and geometrical errors. The proposed method requires neither calibration nor prior information like X-ray spectrum, attenuation properties of the materials and detector response. The algorithm can be used for beam hardening correction in clinical, pre-clinical, and industrial CT systems.

Abstract We present the first visualization tool that enables a comparative depiction of structural stress tensor data for vessel walls of cerebral aneurysms. Such aneurysms bear the risk of rupture, whereas their treatment also carries considerable risks for the patient. Medical researchers emphasize the importance of analyzing the interaction of morphological and hemodynamic information for the patient‐specific rupture risk evaluation and treatment analysis. Tensor data such as the stress inside the aneurysm walls characterizes the interplay between the morphology and blood flow and seems to be an important rupture‐prone criterion. We use different glyph‐based techniques to depict local stress tensors simultaneously and compare their applicability to cerebral aneurysms in a user study. We thus offer medical researchers an effective visual exploration tool to assess the aneurysm rupture risk. We developed a GPU‐based implementation of our techniques with a flexible interactive data exploration mechanism. Our depictions are designed in collaboration with domain experts, and we provide details about the evaluation.

We present the first visualization tool that combines patient-specific hemodynamics with information about the vessel wall deformation and wall thickness in cerebral aneurysms. Such aneurysms bear the risk of rupture, whereas their treatment also carries considerable risks for the patient. For the patient-specific rupture risk evaluation and treatment analysis, both morphological and hemodynamic data have to be investigated. Medical researchers emphasize the importance of analyzing correlations between wall properties such as the wall deformation and thickness, and hemodynamic attributes like the Wall Shear Stress and near-wall flow. Our method uses a linked 2.5D and 3D depiction of the aneurysm together with blood flow information that enables the simultaneous exploration of wall characteristics and hemodynamic attributes during the cardiac cycle. We thus offer medical researchers an effective visual exploration tool for aneurysm treatment risk assessment. The 2.5D view serves as an overview that comprises a projection of the vessel surface to a 2D map, providing an occlusion-free surface visualization combined with a glyph-based depiction of the local wall thickness. The 3D view represents the focus upon which the data exploration takes place. To support the time-dependent parameter exploration and expert collaboration, a camera path is calculated automatically, where the user can place landmarks for further exploration of the properties. We developed a GPU-based implementation of our visualizations with a flexible interactive data exploration mechanism. We designed our techniques in collaboration with domain experts, and provide details about the evaluation.

Abstract The qualitative exploration of near‐wall hemodynamics in cerebral aneurysms provides important insights for risk assessment. For instance, a direct relation between complex flow patterns and aneurysm formation could be observed. Due to the high complexity of the underlying time‐dependent flow data, the exploration is challenging, in particular for medical researchers not familiar with such data. We present the AmniVis‐Explorer, a system that is designed for the preparation of a qualitative medical study. The provided features were developed in close collaboration with medical researchers involved in the study. This comprises methods for a purposeful selection of surface regions of interest and a novel approach to provide a 2D overview of flow patterns that are represented by streamlines at these regions. Furthermore, we present a specialized interface that supports binary classification of patterns and temporal exploration as well as methods for selection, highlighting and automatic 3D navigation to particular patterns. Based on eight representative datasets, we conducted informal interviews with two bord‐certified radiologists and a flow expert to evaluate the system. It was confirmed that the AmniVis‐Explorer allows for an easy selection, qualitative exploration and classification of near‐wall flow patterns that are represented by streamlines.

Cerebral aneurysms are a pathological vessel dilatation that bear a high risk of rupture. For the understanding and evaluation of the risk of rupture, the analysis of hemodynamic information plays an important role. Besides quantitative hemodynamic information, also qualitative flow characteristics, e.g., the inflow jet and impingement zone are correlated with the risk of rupture. However, the assessment of these two characteristics is currently based on an interactive visual investigation of the flow field, obtained by computational fluid dynamics (CFD) or blood flow measurements. We present an automatic and robust detection as well as an expressive visualization of these characteristics. The detection can be used to support a comparison, e.g., of simulation results reflecting different treatment options. Our approach utilizes local streamline properties to formalize the inflow jet and impingement zone. We extract a characteristic seeding curve on the ostium, on which an inflow jet boundary contour is constructed. Based on this boundary contour we identify the impingement zone. Furthermore, we present several visualization techniques to depict both characteristics expressively. Thereby, we consider accuracy and robustness of the extracted characteristics, minimal visual clutter and occlusions. An evaluation with six domain experts confirms that our approach detects both hemodynamic characteristics reasonably.

Abstract For cerebral aneurysms, the ostium, the area of inflow, is an important anatomic landmark, since it separates the pathological vessel deformation from the healthy parent vessel. A better understanding of the inflow characteristics, the flow inside the aneurysm and the overall change of pre‐ and post‐aneurysm flow in the parent vessel provide insights for medical research and the development of new risk‐reduced treatment options. We present an approach for a qualitative, visual flow exploration that incorporates the ostium and derived anatomical landmarks. It is divided into three scopes: a global scope for exploration of the in‐ and outflow, an ostium scope that provides characteristics of the flow profile close to the ostium and a local scope for a detailed exploration of the flow in the parent vessel and the aneurysm. The approach was applied to five representative datasets, including measured and simulated blood flow. Informal interviews with two board‐certified radiologists confirmed the usefulness of the provided exploration tools and delivered input for the integration of the ostium‐based flow analysis into the overall exploration workflow.

Blood flow and derived data are essential to investigate the initiation and progression of cerebral aneurysms as well as their risk of rupture. An effective visual exploration of several hemodynamic attributes like the wall shear stress (WSS) and the inflow jet is necessary to understand the hemodynamics. Moreover, the correlation between focus-and-context attributes is of particular interest. An expressive visualization of these attributes and anatomic information requires appropriate visualization techniques to minimize visual clutter and occlusions. We present the FLOWLENS as a focus-and-context approach that addresses these requirements. We group relevant hemodynamic attributes to pairs of focus-and-context attributes and assign them to different anatomic scopes. For each scope, we propose several FLOWLENS visualization templates to provide a flexible visual filtering of the involved hemodynamic pairs. A template consists of the visualization of the focus attribute and the additional depiction of the context attribute inside the lens. Furthermore, the FLOWLENS supports local probing and the exploration of attribute changes over time. The FLOWLENS minimizes visual cluttering, occlusions, and provides a flexible exploration of a region of interest. We have applied our approach to seven representative datasets, including steady and unsteady flow data from CFD simulations and 4D PC-MRI measurements. Informal user interviews with three domain experts confirm the usefulness of our approach.

Abstract Cerebral aneurysms result from a congenital or evolved weakness of stabilizing parts of the vessel wall and potentially lead to rupture and a life‐threatening bleeding. Current medical research concentrates on the integration of blood flow simulation results for risk assessment of cerebral aneurysms. Scalar flow characteristics close to the aneurysm surface, such as wall shear stress, form an important part of the simulation results. Aneurysms exhibit variable surface shapes with only few landmarks. Therefore, the exploration and mental correlation of different surface regions is a difficult task. In this paper, we present an approach for the intuitive and interactive overview visualization of near wall flow data that is mapped onto the surface of a 3D model of a cerebral aneurysm. We combine a multi‐perspective 2D projection map with a standard 3D visualization and present techniques to facilitate the correlation between a 3D model and a related 2D map. An informal evaluation with 4 experienced radiologists has shown that the map‐based overview actually improves the surface exploration. Furthermore, different color schemes were discussed and, as a result, an appropriate color scheme for the visual analysis of the wall shear stress is presented.