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Although the need to quantify the anatomical dimensions of coronary arterial atherosclerotic lesions is well recognized, standard analysis using 35 mm cine film precludes this technology during interventional procedures. The advent of digital radiographic (DR) imaging has caused speculation as to the applicability of electronic imaging to quantitative coronary arteriography. We report here the results of an experimental comparison of the accuracy of automatically determined geometric diameter (GD) and videodensitometric relative cross-sectional area (RA) using a radiographic arterial phantom. The phantom consists of a plexiglass plate with seven arterial models with "lesions" which vary from 0.5 mm to 3.0 mm diameter and proximal/distal lumena varying from 1.0 to 5.0 mm diameter. DR images at 512 x 512 resolution were preprocessed to correct for pincushion distortion and then analyzed using a quantification program which uses automatic edge detection to calculate GD and RA. Regression analysis of actual vs measured GD and RA yields excellent results. GD measurements show an overestimation of lumena with diameters less than 1.0 mm. RA, however, is not affected by this problem and yields accurate estimation down to the the 1% range. Geometric diameter percent stenosis as a result is overestimated in very small lumena, but RA percent stenosis yields accurate results over the range from 20% to 99%. As the program runs in less than 30 seconds, we conclude that DR imaging enables immediate quantitative coronary arteriography.
LeFree et al. (Thu,) studied this question.