OBJECTIVES:To study the possible effects on quantitative coronary or vascular analyses (QCA and QVA) on images of a flat-panel-based (FP-based) system. BACKGROUND:Since a few years, more and more cardiovascular X-ray imaging systems are equipped with flat-panel detectors, replacing the conventional image intensifiers in combination with CCD cameras for the creation of the angiographic images. METHODS:To assess any differences in QCA and QVA results from these two types of digital X-ray imaging systems, we performed a quantitative comparison study on images of the Medis coronary and vascular phantom, respectively. All phantom images were acquired on both a FP-based and an image intensifier-based (II-based) imaging system with different system settings (3 different kV-levels and 4 field of view sizes). RESULTS:The QCA and QVA results showed that all the systematic and random errors for the subsets of the FP-based and II-based systems were very small and satisfy the QCA and QVA reference guidelines, though some of the subsets of the FP-based and II-based coronary and vascular phantom images demonstrate a statistically significant difference. However, given the small magnitude of these under- and overestimations under phantom conditions, these differences are considered clinically irrelevant. CONCLUSIONS:The image characteristics of the FP-based images do not have any significant influence on the results of QCA and QVA analyses. As a consequence, a further optimization of the contour detection algorithm is not necessary for FP-based images, and data from both II-based and FP-based X-ray imaging systems can be used collectively in (multicenter) clinical trials.

译文

目的:研究基于平板(基于FP)系统的图像对定量冠状动脉或血管分析(QCA和QVA)的可能影响。
背景:自几年以来,越来越多的心血管X射线成像系统配备了平板检测器,取代了传统的图像增强器和CCD相机,以创建血管造影图像。
方法:为了评估这两种类型的数字X射线成像系统在QCA和QVA结果方面的差异,我们分别对Medis冠状动脉和血管体模的图像进行了定量比较研究。在具有不同系统设置(3个不同的kV级和4个视场大小)的系统设置的基于FP和基于图像增强器(II)的成像系统上均采集了所有幻像图像。
结果:QCA和QVA结果表明,基于FP的系统和基于II的系统的子集的所有系统误差和随机误差均很小,并且满足基于QCA和QVA的参考准则,尽管基于FP的一些子集和基于II的冠状动脉和血管幻影图像显示出统计学上的显着差异。但是,鉴于在幻影条件下这些低估和高估的幅度很小,这些差异在临床上被认为是无关紧要的。
结论:基于FP的图像的图像特征对QCA和QVA分析的结果没有任何显着影响。结果,对于基于FP的图像,轮廓检测算法的进一步优化不是必需的,并且来自基于II的和基于FP的X射线成像系统的数据都可以在(多中心)临床试验中共同使用。

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