Accuracy and precision of quantitative digital coronary arteriography; observer-, as well as short- and medium-term variabilities

Abstract

Over the last decade and particularly in the last few years, intervention cardiology has grown at an unforseen pace. In addition to the now “conventional” intervention techniques such as thrombolysis and balloon dilatation, other rapidly evolving techniques for transluminal revascularization or recanalization, such as stent implantation, laser ablation, mechanical atherectomy approaches, etc. have been and are being developed and validated at many research centers. In parallel to and partly triggered by these clinical developments, there has been a significant progress in X-ray imaging technology. Image quality is continually improving due to the availability of higher quality X-ray sources, image intensifiers, TV chains, the use of pulsed fluoroscopy, and real-time image enhancement. It is now also possible to store the dynamic pictorial information on-line in digital format at relatively high spatial and temporal resolution [1–3]. The application of gap filling techniques allows a reduction in the acquisiton frame rates with a concommitant reduction in X-ray radiation dose. These clinical and technical forces running in parallel, put pressure on the availability of quantitative data on coronary artery dimensions at the time of the cardiac catheterization procedure (on-line) or shortly thereafter on the basis of the digitally acquired arteriograms, as well as offline from 35 mm cinefilm.