Quality control in performing quantitative coronary arteriography

Computer-based techniques have been and are being developed to obtain objective and reproducible parameters on the extent and severity of coronary artery disease from coronary (cine)angiograms. To evaluate changes in arterial dimensions over time, repeated cineangiographies need to be performed and analyzed. However, the quality of both the angiographic investigation and the subsequent computer analysis are hampered by various sources of variation. To obtain reliable and reproducible quantitative results from coronary cineangiograms, these variations should be minimized as much as possible. In this article, approaches toward standardized cineantiographic acquisition and analysis procedures are presented. It is known that without these precautions taken, the variability in absolute coronary dimensions may increase dramatically. On the other hand, when these precautions are followed, the variability in absolute dimensions from repeated cineangiongrams and analyses increase only by a factor of 1.5 to 2.2 as compared with those from repeated cinefilm analysis alone.