First direct in vivo comparison of two commercially available three‐dimensional quantitative coronary angiography systems

Abstract

Aim: The in vivo comparison of the accuracy of two 3-dimensional quantitative coronary angiography (QCA) systems. Methods: Precision-drilled plexiglass phantoms with five different luminal diameters (0.5-1.9 mm) were percutaneously inserted into the coronary arteries of four Yorkshire pigs. Twenty-one angiographic images of these stenotic phantoms were acquired for in vivo validation testing. Quantitative assessments of the minimum, maximum, and mean luminal diameters together with the minimum luminal area were determined using two 3D QCA systems, the CardiOp-B 1 and CAAS 5. Results: The CardiOp-B system significantly underestimated the minimum luminal diameter MLD whilst both systems significantly overestimated the maximum luminal diameter at the minimal luminal area (MLA) over the phantom's true value. The CAAS 5 system had a greater degree of accuracy/mm (mean difference 5 0.01 vs. 0.03) and precision/mm (SD 5 0.09 vs. 0.23) than the CardiOp-B in assessing the minimal LD. An increased precision/mm (SD 5 0.01 vs. 0.29) and accuracy/mm (mean difference 5 0.03 vs. 0.11) in the mean LD was observed with the CAAS 5. In comparing the MLA/mm 2 the CAAS 5 was more precise/mm 2 (SD 5 0.14 vs. 0.55) and accurate/mm 2 (mean difference 5 0.12 vs. 0.02) to the true phantom MLA compared to the CardiOp-B system. Conclusions: In a 21 phantom study, the CAAS 5 3D QCA system had a greater degree of accuracy and precision in both the luminal and area measurements than the CardiOp-B 3D QCA system. '

Comparison of 3-dimensional and 2-dimensional quantitative coronary analysis measuring intracoronary lengths in patients undergoing diagnostic coronary angiography

“…more precise stent selection, tackling chronic total occlusions, remote or robotic guidance of PCI). But only recently have the advances in computer power made simple and fast 3-dimensional rendering of angiographic images possible [6][7][8][9][10]. Three-dimensional angiography proved useful in assessment of one of the most complex interventional challenges, left main coronary anatomy [20].…”

“…Although 2D QCA has been well validated in phantoms and its reproducibility is well established, foreshortening of the arterial segment of interest in a two-dimensional image continues to be a significant problem when determining lesion length, eccentricity, and tortuosity [2,3]. Due to these limitations, coronary angiography modeling using threedimensional QCA on the basis of images and structures visualized and captured during standard and rotational angiography was introduced [4,5] and is currently being evaluated for its utility in clinical practice [6][7][8][9][10].…”

Quantitative Coronary Angiography in the Interventional Cardiology

“…However, the systems differ in their calibration methods. CardiOp-B requires the operator to input the size of the catheter in the image into the program, whereas the Medis and CAAS 5 systems automatically calibrates the images using DICOM (Digital Imaging and Communications in Medicine) information embedded in the angiographic images (Gradaus et al, 2006;Ramcharitar et al, 2008a). Once the image is created, operators can manipulate the images by zooming in or rotating the image.…”

“…However, comparisons of 3D QCA programs to conventional 2D QCA programs have shown mixed results regarding the accuracy of this technology (Ramcharitar www.intechopen.com et al, 2008a;Dvir et al, 2005;Tsuchida et al, 2007;Meerkin et al, 2010;Wellnhofer et al, 1999;Tu et al, 2010). One small study has compared the two current 3D QCA programs using phantom models demonstrated that the CAAS 5 system may be more accurate than the CardiOp-B system (Ramcharitar et al, 2008a). …”

Wall Shear Stress Distribution in Patient Specific Coronary Artery Bifurcation

“…With the development of Computed Tomography (CT), MRI angiography and rotational angiography, patient-specific 3D geometries of coronary arteries are readily available for studies of hemodynamics and resulted in a number of recently published researches (Ramcharitar et al, 2008;Gijsen et al, 2008;van der Giessen et al, 2009;Goubergrits et al, 2009;.…”