CT angiography of peripheral arterial bypass grafts: Accuracy and time-effectiveness of quantitative image analysis with an automated software tool.
OBJECTIVE
Qualitative analysis of computed tomography (CT) angiography data often is limited by intra- and interobserver variability. The purpose of this study was to evaluate the time-effectiveness and accuracy of a quantitative CT angiography data analysis using automated software in comparison with qualitative axial and coronal CT image reading in patients with peripheral bypass grafts.


METHODS
Twenty-eight patients with 33 saphenous bypass grafts underwent 4-channel (n = 21) and 16-channel (n = 7) CT angiography. Two readers evaluated in consensus the CT data qualitatively on axial and coronal reconstructions and with the software regarding the presence of graft stenoses, aneurysmal changes, and arteriovenous fistulas. The time for data analysis was taken and the accuracy was compared with the results from digital subtraction angiography (DSA).


RESULTS
No significant difference was present between data analysis time using axial and coronal CT images (4.9 +/- 1.5 minutes) and when using the software tool (5.5 +/- 1.4 minutes). Good (kappa = 0.652) to excellent (kappa = 1.000) intermodality agreement was present between qualitative and quantitative CT analysis regarding graft-related abnormalities. Sensitivity and specificity for diagnosing stenoses, aneurysms, and fistula did not differ significantly (P > .025) between qualitative CT image reading and the automated software tool.


CONCLUSIONS
CT angiography analysis of peripheral bypass grafts using an automated software tool is similar regarding time-effectiveness and accuracy when compared with qualitative CT data analysis on axial and coronal images. It may assist in determining the significance of an abnormality and can yield objective morphometric data of vessel calibers.
Keller
Denise
D
Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich.
Wildermuth
Simon
S
Boehm
Thomas
T
Boskamp
Tobias
T
Mayer
Dieter
D
Schuster
Horst L
HL
Marincek
Borut
B
Alkadhi
Hatem
H
D000465:Algorithms; D000792:Angiography / Q000379:methods*; D001185:Artificial Intelligence; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D016247:Information Storage and Retrieval / Q000379:methods; D008297:Male; D008875:Middle Aged; D010363:Pattern Recognition, Automated / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012501:Saphenous Vein / Q000000981:diagnostic imaging* / Q000637:transplantation*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome