Clin Med Insights Cardiol. 2019 Mar 31;13:1179546819838232. doi: 10.1177/1179546819838232. eCollection 2019.
Impact of Cine Frame Selection on Quantitative Coronary Angiography Results.
Clinical Medicine Insights. Cardiology
Shigenori Ito, Kanako Kinoshita, Akiko Endo, Masato Nakamura
Affiliations
Affiliations
- Japan Cardiovascular Imaging Core Laboratory, Tokyo, Japan.
- Division of Cardiology, Nagoya City East Medical Center, Nagoya, Japan.
- Division of Cardiology, Sankuro Hospital, Toyota, Japan.
- Division of Cardiology, Toho University Medical Center Ohashi Hospital, Tokyo, Japan.
PMID: 30967747
PMCID: PMC6444776 DOI: 10.1177/1179546819838232
Abstract
We evaluated intra- and interobserver variability of quantitative coronary angiography (QCA) due to cine frame selection for 9 coronary stenoses. The projection was selected in advance. Cine frames were selected by 2 blinded experts (blind frame QCA) followed by assignment by supervisor (pre-selected frame QCA). Each expert analyzed 18 frames twice with a 3-month interval. A total of 72 measurements by 2 experts were used for intra- and interobserver variability analysis in calibration factor (CF), minimal lumen diameter (MLD), percent diameter stenosis (%DS), interpolated reference diameter (Int R), and lesion length (LL). Accuracy, precision, and coefficient of variation (CV) were calculated based on 2 measurements. For interobserver variability, intraclass correlation coefficient (ICC) was evaluated. Regarding intraobserver variability, precision (CV) was 0.0026 (1.45), 0.220 (25.1), 0.282 (11.0), 7.626 (11.8), and 4.042 (28.7) for blind frame QCA and 0.0044 (2.46), 0.094 (11.2), 0.225 (8.6), 3.924 (5.9), and 1.941 (12.1) for pre-selected frame QCA and regarding interobserver variability, precision (CV) was 0.0037 (2.09), 0.271 (31.8), 0.307 (11.9), 10.10 (15.4), and 5.121 (39.5) for blind frame QCA and 0.0050 (2.82), 0.098 (11.4), 0.246 (9.5), 5.253 (8.0), and 2.857 (19.0) for pre-selected frame QCA in CF, MLD, Int R, %DS, and LL, respectively. Intraclass correlation coefficient of Int R was almost perfect in blind and pre-selected frame QCA. Intraclass correlation coefficient of MLD, %DS, and LL were substantial/lower by blind frame QCA and improved to almost perfect by pre-selected frame QCA. Blind cine film selection might affect intra- and interobserver variability, especially in MLD and LL. In the multiple linear regression analysis, blind frame QCA was selected as an explanatory factor of QCA variability in MLD, %DS, and LL. The error range due to frame selection must be taken into consideration in clinical use.
Keywords: cardiac cycle; core laboratory; coronary intervention; coronary stenosis; frame selection; minimal lumen diameter; quantitative coronary angiography
Conflict of interest statement
Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
References
- Catheter Cardiovasc Interv. 2002 Jul;56(3):333-40 - PubMed
- Catheter Cardiovasc Interv. 2005 Apr;64(4):460-7 - PubMed
- J Interv Cardiol. 2009 Dec;22(6):527-36 - PubMed
- Eur Heart J. 1989 Nov;10 Suppl F:54-9 - PubMed
- J Clin Invest. 1989 Feb;83(2):520-6 - PubMed
- Heart Vessels. 2016 Nov;31(11):1752-1757 - PubMed
- Int J Comput Assist Radiol Surg. 2018 Aug;13(8):1159-1167 - PubMed
- Cathet Cardiovasc Diagn. 1988;14(4):221-8 - PubMed
- Circulation. 1985 Feb;71(2):280-8 - PubMed
- Cathet Cardiovasc Diagn. 1993 Aug;29(4):314-21 - PubMed
- J Am Coll Cardiol. 1993 Oct;22(4):1068-74 - PubMed
- Cathet Cardiovasc Diagn. 1996 Jan;37(1):24-31 - PubMed
- Int J Card Imaging. 1996 Sep;12(3):197-203 - PubMed
Publication Types