title: CT angiography of peripheral arterial bypass grafts: Accuracy and time-effectiveness of quantitative image analysis with an automated software tool.
abstract: 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.
authors.affiliation: Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich.
authors.forename: Denise
authors.initials: D
authors.lastname: Keller
authors.forename: Simon
authors.initials: S
authors.lastname: Wildermuth
authors.forename: Thomas
authors.initials: T
authors.lastname: Boehm
authors.forename: Tobias
authors.initials: T
authors.lastname: Boskamp
authors.forename: Dieter
authors.initials: D
authors.lastname: Mayer
authors.forename: Horst L
authors.initials: HL
authors.lastname: Schuster
authors.forename: Borut
authors.initials: B
authors.lastname: Marincek
authors.forename: Hatem
authors.initials: H
authors.lastname: Alkadhi
mesh_terms: 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