Accuracy and reproducibility of automated, standardized coronary transluminal attenuation gradient measurements.
Accuracy and reproducibility of automated, standardized coronary transluminal attenuation gradient measurements.
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DOI：
10.1007/s10554-014-0446-4
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发表时间：
2014-08
影响因子：
2.1
通讯作者：
Mitsouras, Dimitrios
中科院分区：
文献类型：
--
作者：
Chatzizisis, Yiannis S.;George, Elizabeth;Cai, Tianrun;Fulwadhva, Urvi P.;Kumamaru, Kanako K.;Schultz, Kurt;Fujisawa, Yasuko;Rassi, Carlos;Steigner, Michael;Mather, Richard T.;Blankstein, Ron;Rybicki, Frank J.;Mitsouras, Dimitrios
关键词：
冠状动脉CT血管造影(CCTA)对比剂混浊梯度或经管腔衰减梯度(TAG)为预测有意义的功能性病变提供了增量价值。这项研究介绍并评估了一个自动梯度软件包，该软件包可以潜在地取代当前劳动密集型的手动标签计算方法。对20例患者的60支主要冠状动脉进行了临床显示的单次心脏搏动320×0.5 mm探测器行CCTA检查，两名阅读器使用先前验证的手动测量方法和另外两名使用新的自动梯度软件的阅读器对其进行了回顾性评估。以人工测量为参考标准，通过线性回归和Bland-Altman分析评估自动化方法的准确性。还评估了观察者间和观察者内的重复性，以及可能影响手动和自动标签测量的准确性或重复性的因素，包括CAD严重性和迭代重建。与手动标签测量相比，分析时间减少了68%。自动标签与参考标准手动标签之间有很好的相关性。Bland-Altman分析表明，与手动测量相比，自动化测量的平均差异较小(1HU/cm)，观察者间和观察者内部的一致性限制较窄(自动化软件分别减少了25%和36%)。在评估的患者和技术因素中，没有任何因素影响手动和自动标签测量的一致性。自动320×0.5 mm探测器行梯度软件将计算时间减少68%，具有高精度和重复性。
Coronary Computed Tomography Angiography (CCTA) contrast opacification gradients, or Transluminal Attenuation Gradients (TAG) offer incremental value to predict functionally significant lesions. This study introduces and evaluates an automated gradients software package that can potentially supplant current, labor-intensive manual TAG calculation methods. All 60 major coronary arteries in 20 patients who underwent a clinically indicated single heart beat 320×0.5 mm detector row CCTA were retrospectively evaluated by two readers using a previously validated manual measurement approach and two additional readers who used the new automated gradient software. Accuracy of the automated method against the manual measurements, considered the reference standard, was assessed via linear regression and Bland-Altman analyses. Inter- and intra-observer reproducibility and factors that can affect accuracy or reproducibility of both manual and automated TAG measurements, including CAD severity and iterative reconstruction, were also assessed. Analysis time was reduced by 68% when compared to manual TAG measurement. There was excellent correlation between automated TAG and the reference standard manual TAG. Bland-Altman analyses indicated low mean differences (1 HU/cm) and narrower inter- and intra-observer limits of agreement for automated compared to manual measurements (25% and 36% reduction with automated software, respectively). Among patient and technical factors assessed, none affected agreement of manual and automated TAG measurement. Automated 320×0.5 mm detector row gradient software reduces computation time by 68% with high accuracy and reproducibility.
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