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Accuracy of uncalibrated 2D digital subtraction angiography measurements on a novel biplane system compared to computed tomography angiography

Landström, Lovisa and Wasselius, Johan A. LU (2023) In Interventional Neuroradiology
Abstract

Background: 2D digital subtraction angiography (DSA) images are the gold standard for neuroradiological vascular assessment and the basis of interventional procedures such as mechanical thrombectomy and cerebral aneurysm coiling. However, length measurements in projected DSA images are affected by the distance between the x-ray source, the object, and the detector. Precise coordination between all integrated parts of a novel biplane system makes it possible to accurately measure DSA distances without manual calibration. The aim of this study was to compare vascular diameter measurements in uncalibrated DSA images with computed tomography angiography (CTA). Methods: Consecutive patients undergoing interventional neuroradiological... (More)

Background: 2D digital subtraction angiography (DSA) images are the gold standard for neuroradiological vascular assessment and the basis of interventional procedures such as mechanical thrombectomy and cerebral aneurysm coiling. However, length measurements in projected DSA images are affected by the distance between the x-ray source, the object, and the detector. Precise coordination between all integrated parts of a novel biplane system makes it possible to accurately measure DSA distances without manual calibration. The aim of this study was to compare vascular diameter measurements in uncalibrated DSA images with computed tomography angiography (CTA). Methods: Consecutive patients undergoing interventional neuroradiological procedures were retrospectively included. Vascular diameter measurements in the image isocenter and periphery were performed. These measurements were repeated in picture archiving and communication system (PACS) on DSA images and maximum intensity pixel (MIP) CTA images. Results: Forty-two (42) consecutive patients with adequate DSA and CTA images were included in the final analysis. The correlation between vessel diameter measurements in the image isocenter (R2 = 0.81/0.85, p < 0.0001/p < 0.0001 [Reader1/Reader2]), periphery (R2 = 0.85/0.82, p < 0.0001/p < 0.0001 [Reader1/Reader2]), and all measurements combined (R2 = 0.87/0.87, p < 0.0001/p < 0.0001 [Reader1/Reader2]) on DSA and CTA were strong and statistically significant. The interclass correlation coefficient for measurements performed by two independent reviewers was strong (ICC = 0.96, 95% CI 0.92–0.98). Conclusions: The correlations between uncalibrated DSA measurements and CTA for vessel diameter were strong. In addition, there were strong correlations between these image types for repeated measurements in the image isocenter as well as image periphery for vessel diameter. Consequently, endovascular devices can be sized correctly without the need for pre-operative non-invasive imaging.

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type
Contribution to journal
publication status
epub
subject
keywords
computed tomography angiography, Digital subtraction angiography, direct to angio triage, measurement accuracy, uncalibrated distal measurement
in
Interventional Neuroradiology
publisher
Centauro srl
external identifiers
  • scopus:85153773747
  • pmid:37097890
ISSN
1591-0199
DOI
10.1177/15910199231171656
language
English
LU publication?
yes
id
3ee317e2-0fc1-4e14-a1da-ea7d9a6ec905
date added to LUP
2023-07-14 13:44:09
date last changed
2024-09-21 13:46:24
@article{3ee317e2-0fc1-4e14-a1da-ea7d9a6ec905,
  abstract     = {{<p>Background: 2D digital subtraction angiography (DSA) images are the gold standard for neuroradiological vascular assessment and the basis of interventional procedures such as mechanical thrombectomy and cerebral aneurysm coiling. However, length measurements in projected DSA images are affected by the distance between the x-ray source, the object, and the detector. Precise coordination between all integrated parts of a novel biplane system makes it possible to accurately measure DSA distances without manual calibration. The aim of this study was to compare vascular diameter measurements in uncalibrated DSA images with computed tomography angiography (CTA). Methods: Consecutive patients undergoing interventional neuroradiological procedures were retrospectively included. Vascular diameter measurements in the image isocenter and periphery were performed. These measurements were repeated in picture archiving and communication system (PACS) on DSA images and maximum intensity pixel (MIP) CTA images. Results: Forty-two (42) consecutive patients with adequate DSA and CTA images were included in the final analysis. The correlation between vessel diameter measurements in the image isocenter (R<sup>2</sup> = 0.81/0.85, p &lt; 0.0001/p &lt; 0.0001 [Reader1/Reader2]), periphery (R<sup>2</sup> = 0.85/0.82, p &lt; 0.0001/p &lt; 0.0001 [Reader1/Reader2]), and all measurements combined (R<sup>2</sup> = 0.87/0.87, p &lt; 0.0001/p &lt; 0.0001 [Reader1/Reader2]) on DSA and CTA were strong and statistically significant. The interclass correlation coefficient for measurements performed by two independent reviewers was strong (ICC = 0.96, 95% CI 0.92–0.98). Conclusions: The correlations between uncalibrated DSA measurements and CTA for vessel diameter were strong. In addition, there were strong correlations between these image types for repeated measurements in the image isocenter as well as image periphery for vessel diameter. Consequently, endovascular devices can be sized correctly without the need for pre-operative non-invasive imaging.</p>}},
  author       = {{Landström, Lovisa and Wasselius, Johan A.}},
  issn         = {{1591-0199}},
  keywords     = {{computed tomography angiography; Digital subtraction angiography; direct to angio triage; measurement accuracy; uncalibrated distal measurement}},
  language     = {{eng}},
  publisher    = {{Centauro srl}},
  series       = {{Interventional Neuroradiology}},
  title        = {{Accuracy of uncalibrated 2D digital subtraction angiography measurements on a novel biplane system compared to computed tomography angiography}},
  url          = {{http://dx.doi.org/10.1177/15910199231171656}},
  doi          = {{10.1177/15910199231171656}},
  year         = {{2023}},
}