Reliability and Accuracy of Peri-Interventional Stenosis Grading in Peripheral Artery Disease Using Color-Coded
Patrick Ghibes1,2, Sasan Partovi3, Gerd Grözinger1
1Diagnostic and Interventional Radiology, Eberhard-Karls-University, Tübingen, Germany.
Biomed Research International
|August 25, 2018
Summary
Color-coded fluoroscopy effectively grades stenosis using area under the curve (AUC) from time-density curves (TDC). Optimizing integration time, region of interest (ROI) size, and frame rate enhances accuracy for quantitative stenosis assessment.
Area of Science:
- Medical Imaging
- Hemodynamics
- Quantitative Analysis
Background:
- Stenosis grading is crucial for cardiovascular disease management.
- Color-coded fluoroscopy offers a potential method for quantitative stenosis assessment.
Purpose of the Study:
- To evaluate the accuracy of quantitative stenosis grading using color-coded fluoroscopy in an in vitro pulsatile flow phantom.
- To compare different hemodynamic parameters derived from time-density curves (TDC).
Main Methods:
- Utilized contrast-enhanced fluoroscopy with a flat-detector system on stenotic tubes (80%, 60%, 40% diameter restriction).
- Analyzed time-density curves (TDC), area under the curve (AUC), and time-to-peak (TTP) using two postprocessing software solutions.
- Investigated the impact of region of interest (ROI) size and integration times on results.
Main Results:
- Color-coded fluoroscopy successfully differentiated between various stenosis degrees based on AUC and TDC.
- Area under the curve (AUC) in ROIs behind the stenosis showed the best correlation with stenosis severity (rho=0.9284 at 5s integration time).
- Time-to-peak (TTP) did not significantly differentiate between high- and low-grade stenosis.
Conclusions:
- Area under the curve (AUC) derived from time-density curves (TDC) is a reliable parameter for quantitative stenosis grading.
- Optimizing integration times, ROI size, and frame rate significantly improves the accuracy of AUC measurements.
- Color-coded fluoroscopy, with optimized parameters, provides a reproducible method for stenosis assessment.
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