In-vivo validation of on-line and off-line geometric coronary measurements using insertion of stenosis phantoms in porcine coronary arteries.

Geometric coronary artery measurements with the Phillips Digital Cardiac Imaging System (DCI) and the Cardiovascular Angiography Analysis System (CAAS) were validated using percutaneous insertion of radiolucent stenosis phantoms in swine coronary arteries. Angiographic visualization of the stenosis lumens (phi 0.5, 0.7, 1.0, 1.4, 1.9 mm) was simultaneously recorded on DCI and cinefilm. The acquisition systems were calibrated by either the diameter of the guiding catheter (catheter CAL) or the isocenter method (isocenter CAL). Minimal luminal diameters (MLD) obtained with CAAS and DCI on 20 corresponding cineframes were compared with the true phantom diameters (PD). The accuracy of MLD measurements with the CAAS using isocenter CAL was -0.07mm, the precision 0.21 mm (r = 0.91; y = 0.30 + 0.79x; SEE = 0.19), with catheter CAL the accuracy was 0.09 mm, the precision 0.23 mm (r = 0.89; y = 0.19 + 0.74x; SEE = 0.19). The accuracy of MLD measurements using the DCI with isocenter CAL was 0.08 mm, the precision 0.15 min (r = 0.96; y = 0.08 + 0.86x; SEE = 0.14), with catheter CAL the accuracy was 0.18 mm, the precision 0.21 mm (r = 0.92; y = 0.09 + 0.76x; SEE = 0.17). DCI underestimated PD with isocenter CAL (p less than 0.05) and with catheter CAL (p less than 0.001). MLD can be measured with high accuracy, both applying on-line digital as well as off-line cineangiographic analysis. The results of digital measurements demonstrate high reliability of the new digital software package.

[1]  G. Heninger,et al.  PHENOXYBENZAMINE IN ANOREXIA NERVOSA , 1976, The Lancet.

[2]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[3]  L. Santoro,et al.  Pitfalls in the determination of absolute dimensions using angiographic catheters as calibration devices in quantitative angiography. , 1991, The American journal of cardiology.

[4]  Helmut Wollschläger,et al.  Optimal biplane imaging of coronary segments with computed triple orthogonal projections , 1988 .

[5]  Johan H. C. Reiber,et al.  An overview of coronary quantitation techniques as of 1989 , 1991 .

[6]  M. LeFree,et al.  Automated quantitative coronary arteriography: morphologic and physiologic validation in vivo of a rapid digital angiographic method. , 1987, Circulation.

[7]  J. J. Gerbrands,et al.  Coronary Artery Dimensions from Cineangiograms-Methodology and Validation of a Computer-Assisted Analysis Procedure , 1984, IEEE Transactions on Medical Imaging.

[8]  Erik L. Ritman,et al.  Coronary angiographic examination with the dynamic spatial reconstructor. , 1984 .

[9]  Johan H. C. Reiber,et al.  Quantitative Coronary Arteriography , 1991 .

[10]  P D Esser,et al.  Quantification of relative coronary arterial stenosis by cinevideodensitometric analysis of coronary arteriograms. , 1984, Circulation.

[11]  N J Mankovich,et al.  Quantitative coronary arteriography: design and validation. , 1988, Radiology.

[12]  M J Davies,et al.  Potential errors in the estimation of coronary arterial stenosis from clinical arteriography with reference to the shape of the coronary arterial lumen. , 1986, British heart journal.

[13]  P J de Feyter,et al.  Quantitative coronary angiography to measure progression and regression of coronary atherosclerosis. Value, limitations, and implications for clinical trials. , 1991, Circulation.

[14]  J. J. Gerbrands,et al.  Assessment of short-, medium-, and long-term variations in arterial dimensions from computer-assisted quantitation of coronary cineangiograms. , 1985, Circulation.

[15]  Raymond J. Lewis,et al.  DIGITAL RADIOGRAPHIC CORONARY ARTERY QUANTIFICATION. , 1985 .

[16]  J. J. Gerbrands,et al.  An on-line system for the quantitative analysis of coronary arterial segments , 1989, [1989] Proceedings. Computers in Cardiology.

[17]  P. Serruys,et al.  Restenosis after coronary angioplasty: new standards for clinical studies. , 1990, Journal of the American College of Cardiology.

[18]  P J de Feyter,et al.  Change in diameter of coronary artery segments adjacent to stenosis after percutaneous transluminal coronary angioplasty: failure of percent diameter stenosis measurement to reflect morphologic changes induced by balloon dilation. , 1988, Journal of the American College of Cardiology.

[19]  C. J. Kooijman,et al.  Assessment of dimensions and image quality of coronary contrast catheters from cineangiograms. , 1985, Catheterization and cardiovascular diagnosis.

[20]  P W Serruys,et al.  Incidence of restenosis after successful coronary angioplasty: a time-related phenomenon. A quantitative angiographic study in 342 consecutive patients at 1, 2, 3, and 4 months. , 1988, Circulation.

[21]  E R Bates,et al.  A comparison of 35 mm cine film and digital radiographic image recording: implications for quantitative coronary arteriography. Film vs. digital coronary quantification. , 1988, Investigative radiology.