Accuracy of quantitative coronary angiography for different directions of the coronary artery

: We evaluated the effect of changes in the direction of the coronary artery in terms of the accuracy and precision of vessel diameter measurement in a quantitative coronary angiography system (QCA system). Vessel phantoms sized 0.3, 0.5, 1.0, 1.5, 2.0, and 2.5 mm in diameter were evaluated. The phantoms were aligned on an acrylic plate, and the angle to the television (TV) camera was altered. The deployed angles were 0 (perpendicular), 45, 90, and 135 degrees in clockwise order. The phantoms were imaged with matrices of 1024 x 1024 (1024(2)), 512 x 512 (512(2)), and 512 x 1024. Image size was 7 inches, and the frame rate was 15 frames per second. Minimal lumen diameters were measured on the ACA system. The results revealed that, in the 1024(2) matrix, overall accuracy for the 90-degree angle was significantly underestimated compared with the 0-degree angle (-0.14 vs. -0.014 mm; p=0.007). Accuracy for the 90-degree angle was better than that for the 0-degree angle when the vessel diameter was 1 mm or smaller (-0.02+/-0.16 vs. 0.10+/-0.22 mm). In addition, precision was better at the 90-degree angle than with the other angles in the 1024(2) matrix (overall precision=0.002 mm). In the 512(2) matrix, overall accuracy for the 90-degree angle was significantly underestimated compared with the 45-degree angle (-0.077 vs. 0.096 mm; p=0.02). In addition, accuracy for the 90-degree angle was better than that for the 45-degree angle below 1 mm (0.05+/-0.24 mm vs. 0.26+/-0.47 mm). In terms of overall accuracy, the 45-degree angle in the 512(2) matrix showed significant overestimation compared with that in the 1024(2) matrix (0.096 vs. -0.069 mm; p=0.015). There was no difference in accuracy in the 512 x 1024 matrix. Our results suggest that the direction of the vessel against the TV image affects accuracy of measurement in the QCA system.