title: Variability in quantitative and qualitative analysis of intravascular ultrasound and frequency domain optical coherence tomography.
abstract: BACKGROUND
  Frequency-domain optical coherence tomography (FD-OCT) is an intravascular imaging technique now available in the United States. However, the importance of level of training required for analysis using intravascular ultrasound (IVUS) and FD-OCT is unclear. The aim of this study was to evaluate inter- and intra-observer variability between expert and beginner analysts interpreting IVUS and FD-OCT images.
  
  
  RESULTS
  Two independent expert analysts and two independent beginner analysts evaluated a total of 226 ± 2 stent cross-sections with IVUS and 232 ± 2 stent cross-sections with FD-OCT in 14 patients after stenting. Inter- and intra-observer variability for determining stent volume index (VI), as well as identifying incomplete stent apposition and dissection were assessed. The inter- and intra-observer variability of stent VI was minimal for both beginner and expert analysts regardless of imaging technology (random variability: 0.38 vs. 0.05 mm(3) /mm for IVUS, 0.26 vs. 0.08 mm(3) /mm for FD-OCT). Although qualitative IVUS analysis at the patient level revealed no significant difference between beginners and experts, this was not the case for FD-OCT. The number of overall qualitative findings noted by beginner and expert analysts were more variable (overestimated or underestimated) with FD-OCT.
  
  
  CONCLUSIONS
  Despite varying levels of training, the increased resolution of FD-OCT compared to IVUS provides better detection and less variability in quantitative image analysis. On the contrary, this increased resolution not only increases the rate but also the variability of detection of qualitative image analysis, especially for beginner analysts.
authors: Division of Cardiovascular Medicine, Stanford University, Stanford, California.
authors: Freddy
authors: F
authors: Abnousi
authors: Katsuhisa
authors: K
authors: Waseda
authors: Teruyoshi
authors: T
authors: Kume
authors: Hiromasa
authors: H
authors: Otake
authors: Osami
authors: O
authors: Kawarada
authors: Celina M
authors: CM
authors: Yong
authors: Peter J
authors: PJ
authors: Fitzgerald
authors: Yasuhiro
authors: Y
authors: Honda
authors: Alan C
authors: AC
authors: Yeung
authors: William F
authors: WF
authors: Fearon
mesh_terms: D000368:Aged; D002983:Clinical Competence; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D015607:Stents; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
keywords: coronary imaging; inter-observer variability; intra-observer variability; optical coherence tomography; reproducibility