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Automatic Remasking of Digital Subtraction Angiography Images in Pulmonary Angiography

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Abstract

In pulmonary angiography, the heartbeat creates artifacts that hinder extraction of blood vessel images in digital subtraction angiography. Remasking according to the cardiac phase of the angiogram may be effective but has yet to be automated. Here, automatic remasking was developed and assessed according to the cardiac phase from electrocardiographic information collected simultaneously with imaging. Manual remasking, fixed remasking, and our proposed automatic remasking were applied to 14 pulmonary angiography series from five participants with either chronic thromboembolic pulmonary hypertension or pulmonary arteriovenous malformation. The processing time and extent of artifacts from the heartbeat were compared. In addition, the peak signal-to-noise ratio (PSNR) was measured from differential images between mask image groups before the injection of the contrast medium to investigate optimal mask images. The mean time required for automatic remasking was 4.7 s/series, a significant reduction in processing time compared with the mean of 266 s/series for conventional manual processing. A visual comparison of the different approaches showed virtually no misregistration artifacts from the heartbeat in manual or automatic remasking according to cardiac phase. The results from measuring the PSNR for differential images between mask image groups also showed that smaller cardiac phase difference and time difference between two images ensure higher PSNR (p < 0.01). Automatic remasking according to the cardiac phase was fast and easy to implement and reduced misregistration artifacts from heartbeat.

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Acknowledgments

This work was supported by KAKENHI 18H00539.

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Authors and Affiliations

  1. Department of Radiological and Medical Laboratory Sciences, Graduate School of Medicine, Nagoya University, 1-1-20 Daiko-minami, Higashi-ku, Nagoya, 461-8673, Japan

    Takashi Mizukuchi & Shuji Koyama

  2. Department of Medical Technique, Nagoya University Hospital, 65 Tsurumai, Showa-ku, Nagoya, 466-8560, Japan

    Takeshi Uemura, Satoru Kondo & Shinji Abe

  3. Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, 466-8560, Japan

    Shiro Adachi

  4. Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, 466-8560, Japan

    Naoki Okumura & Takahisa Kondo

Authors
  1. Takashi Mizukuchi
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  2. Takeshi Uemura
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  3. Satoru Kondo
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  4. Shinji Abe
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  5. Shiro Adachi
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  6. Naoki Okumura
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  7. Takahisa Kondo
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  8. Shuji Koyama
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Corresponding author

Correspondence to Takashi Mizukuchi.

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The present study was approved by the Nagoya University Bioethics Committee (Approval number: 2018–0122).

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Mizukuchi, T., Uemura, T., Kondo, S. et al. Automatic Remasking of Digital Subtraction Angiography Images in Pulmonary Angiography. J Digit Imaging 33, 531–537 (2020). https://doi.org/10.1007/s10278-019-00270-8

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  • DOI: https://doi.org/10.1007/s10278-019-00270-8

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