Skip to main content
SpringerLink
Log in

Reproducibility of quantitative coronary analysis

Assessment of variability due to frame selection, different observers, and different cinefilmless laboratories

  • Articles
  • Published:
The International Journal of Cardiac Imaging Aims and scope Submit manuscript

Abstract

Because of limited storage capacity for digital images, angiographic laboratories without cinefilm are dependent on locally performed quantitative coronary angiography (QCA) in clinical studies. In the present study the intra-and interobserver variability, as well as variability between different laboratories and variability due to frame selection was analyzed. A total of 20 coronary lesions were studied in two different digital laboratories 12±8 days apart. Images were analyzed on-line and after being transferred to a Cardiac Work Station (CWS). There was no significant difference between the measurement situations. For minimal luminal diameter (MLD) precision (SD of signed errors) ranged from 0.12 mm to 0.20 mm, for reference diameter (RD) from 0.15 mm to 0.28 mm, and for percent diameter stenosis (DS) from 4.2% to 5.8%. Overall relative precision was obtained by normalizing the QCA parameters, and was 11.9% for MLD, 7.0% for RD and 8.5% for DS (p<0.001, RD and DS compared to MLD). The overall variability in the interobserver and in the interlaboratory comparisons was 11.2% and 10.4%, respectively (n.s.) (n.s.). Thus the variability of QCA performed in cinefilmless, digital laboratories is small, and within a range making it an useful tool for clinical practice and group comparisons in clinical studies. However, the error range of QCA measurements must be taken into consideration when judging results from individual patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Reiber JHC, Serruys PW, Kooijman CJ, Wijns W, Slager CJ, Gerbrands JJ et al. Assessment of short-, medium- and long-term variations in arterial dimensions from computer-assisted quantitation of coronary cineangiograms. Circulation 1985; 71: 280–8.

    PubMed  Google Scholar 

  2. Hermiller JB, Cusma JT, Spero LA, Fortin DF, Harding MB, Bashore TM. Quantitative and qualitative coronary angiographic analysis: review of methods, utility, and limitations. Cathet Cardiovasc Diagn 1992; 25: 110–31.

    PubMed  Google Scholar 

  3. Strauss BH, Escaned J, Foley DP, Di Mario C, Haase J, Keane D et al. Technologic considerations and practical limitations in the use of quantitative angiography during percutaneous coronary recanalization. Prog Cardiovasc Dis 1994; 36: 343–62.

    PubMed  Google Scholar 

  4. Reiber JHC, van der Zwet PMJ, von Land CD, Koning G, Loois G, Zorm I et al. On-line quantification of coronary arteriograms with the DCI system. Medicamundi 1989; 34: 89–98.

    Google Scholar 

  5. Gronenschild E, Janssen J, Tijdens F. CAASII: A second generation system for off-line and on-line quantitative coronary angiography. Cathet Cardiovasc Diagn 1994; 33: 61–75.

    PubMed  Google Scholar 

  6. Reiber JHC, van der Zwet PMJ, Koning G, von Land CD, van Meurs B, Gerbrands JJ et al. Accuracy and precision of quantitative digital coronary arteriography: observer-, short-, and medium-term variabilities. Cathet Cardiovasc Diagn 1993; 28: 187–98.

    PubMed  Google Scholar 

  7. Haase J, Di Mario C, Slager CJ, van der Giessen WJ, den Boer A, de Feyter PJ et al. In-vivo validation of on-line and off-line geometric coronary measurements using insertion of stenosis phantoms in porcine coronary arteries. Cathet Cardiovasc Diagn 1992; 27: 16–27.

    PubMed  Google Scholar 

  8. Austen WG, Edward JE, Frye RL, Gensini GG, Gott VL, Griffith LSC et al. A reporting system on patients evaluated for coronary artery disease. Report of the ad hoc committee for grading of coronary artery disease Council On Cardiovascular Surgery, American Heart Association Assocoation. Circulation 1975; 51: 7–40.

    Google Scholar 

  9. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307–10.

    PubMed  Google Scholar 

  10. Snedecor GW, Cochran WG. Comparison of two correlated variances in paired samples. Statistical methods. Ames, Iowa: The Iowa State University Press, 1980: 190–191.

    Google Scholar 

  11. Altman DG. Two way analysis of variance. Practical statistics for medical research. London: Chapman & Hall, 1991: 326–333.

    Google Scholar 

  12. Herrington DM, Siebes M, Sokol DK, Siu CO, Walford GD. Variability in measures of coronary lumen dimensions using quantitative coronary angiography. J Am Coll Cardiol 1993; 22: 1068–74.

    PubMed  Google Scholar 

  13. Keane D, Haase J, Slager CJ, van Swijndregt EM, Lehmann KG, Ozaki Y et al. Comparative Validation of Quantitative Coronary Angiography Systems. Results and implications from a multicenter study using a standardized approach. Circulation 1995; 91: 2174–83.

    PubMed  Google Scholar 

  14. Sanz ML, Mancini GBJ, LeFree MT, Mickelson JK, Starling MR, Vogel RA et al. Variability of quantitative digital sub-traction coronary angiography before and after percutaneous transluminal coronary angioplasty. Am J Cardiol 1987; 60: 55–60.

    PubMed  Google Scholar 

  15. Stevenson RN, Roberts RH, Brecker SJ, Timmins J, Wilkinson PD, Balcon R. Comparison of digital angiograms with conventional cineangiograms for the quantitation of coronary artery stenosis before and after angioplasty. Coronary artery disease 1992; 3: 1183–8.

    Google Scholar 

  16. Foley DP, Escaned J, Strauss BH, Di Mario C, Haase J, Keane D et al. Quantitative coronary angiography (QCA) in interventional cardiology: clinical application of QCA measurements. Prog Cardiovasc Dis 1994; 36: 363–84.

    PubMed  Google Scholar 

  17. Ellis SG, Pinto IM, McGillem MJ, De Boe SF, Le Free MT, Mancini GB. Accuracy and reproducibility of quantitative coronary arteriography using 6 and 8 French catheters with cine angiographic. Cathet Cardiovasc Diagn 1991; 22: 52–5.

    PubMed  Google Scholar 

  18. Lespérance J, Bourassa MG, Schwartz L, Hudon G, Laurier J, Eastwood C et al. Definition and measurement of restenosis after successful coronary angioplasty: implications for clinical trials. Am Heart J 1993; 125: 1394–408.

    PubMed  Google Scholar 

  19. Fortin DF, Spero LA, Cusma JT, Santori L, Burgess R, Bashore TM. Pitfalls in determination of absolute dimensions using angiographic catheters as calibration devices in quantitative angiography. Am J Cardiol 1991; 68: 1176–82.

    PubMed  Google Scholar 

  20. Mancini GBJ, Williamson PR, DeBoe SF. Effect of coronary stenosis severity on variability of quantitative arteriography, and implications for interventional trials. Am J Cardiol 1992; 69: 806–807.

    PubMed  Google Scholar 

  21. Gurley JC, Nissen SE, Booth DC, De Maria AN. Influence of operator- and patient-dependent variables on the suitability of automated quantitative coronary arteriography. J Am Coll Cardiol 1992; 19: 1237–43.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Feiring Heart Clinic, N-2093, Feiring, Norway

    Per A. Sirnes, Yngvar Myreng, Per Mølstad & Svein Golf

Authors
  1. Per A. Sirnes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yngvar Myreng
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Per Mølstad
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Svein Golf
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sirnes, P.A., Myreng, Y., Mølstad, P. et al. Reproducibility of quantitative coronary analysis. Int J Cardiac Imag 12, 197–203 (1996). https://doi.org/10.1007/BF01806223

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01806223

Key words

Search

Navigation