Blind cine frame selection increased intraobserver variability for minimal lumen diameter (CV 25.1% vs 11.2%) and lesion length compared to pre-selected frame assignment in quantitative coronary angiography.
Observational (n=9)
Blinded
Does blind cine frame selection compared to pre-selected frame selection affect intra- and interobserver variability in quantitative coronary angiography?
Pre-selecting cine frames for quantitative coronary angiography significantly reduces intra- and interobserver variability compared to blind frame selection, particularly for minimal lumen diameter and lesion length.
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.
Ito et al. (Tue,) conducted a observational in Coronary stenoses (n=9). Blind frame QCA vs. Pre-selected frame QCA was evaluated on Intra- and interobserver variability in QCA measurements. Blind cine frame selection increased intraobserver variability for minimal lumen diameter (CV 25.1% vs 11.2%) and lesion length compared to pre-selected frame assignment in quantitative coronary angiography.