Clinical validation of the new T- and Y-shape models for the quantitative analysis of coronary bifurcations: an interobserver variability study.
OBJECTIVE
This article presents the results of an interobserver validation study of our new T- and Y-shape bifurcation models including their edge segment analyses.


BACKGROUND
Over the last years, the coronary artery intervention procedures have been developed more and more toward bifurcation stenting. Because traditional straight vessel quantitative coronary arteriography (QCA) is not sufficient for these measurements, the need has grown for new bifurcation analysis methods.


METHODS
In this article, our two new bifurcation analysis models are presented, the Y-shape and T-shape model. These models were designed for the accurate measurement of the clinically relevant parameters of a coronary bifurcation, for different morphologies and intervention strategies and include an edge segment analysis, to accurately measure (drug-eluting) stent, stent edge, and ostial segment parameters.


RESULTS
The results of an interobserver validation study of our T-shape and Y-shape analyses are presented, both containing the pre- and post-intervention analyses of each 10 cases. These results are associated with only small systematic and random errors, in the majority of the cases compliant with the QCA guidelines for straight analyses. The results for the edge segment analyses are also very good, with almost all the values within the margins that have been set by our brachytherapy directive.


CONCLUSIONS
Our new bifurcation approaches including their edge segment analyses are very robust and reproducible, and therefore a great extension to the field of quantitative coronary angiography.
Medis Medical Imaging Systems BV, Leiden, The Netherlands.
Joan C
JC
Tuinenburg
Johannes P
JP
Janssen
Rolf
R
Kooistra
Gerhard
G
Koning
Maria D
MD
Corral
Alexandra J
AJ
Lansky
Johan H C
JH
Reiber
D000465:Algorithms; D001331:Automation; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D006801:Humans; D008955:Models, Cardiovascular; D015588:Observer Variation; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome