Measurement of coronary bifurcation angle with coronary CT angiography: A phantom study

Givehchi, Sogol and Safari, Mohammad Javad and Tan, Sock Keow and Shah, Mohammad Nazri Md and Sani, Fadhli Mohamed and Raja Aman, Raja Rizal Azman and Sun, Zhonghua and Yeong, Chai Hong and Ng, Kwan Hoong and Wong, Jeannie Hsiu Ding (2018) Measurement of coronary bifurcation angle with coronary CT angiography: A phantom study. Physica Medica, 45. pp. 198-204. ISSN 1120-1797, DOI

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Purpose: Accurate determination of the bifurcation angle and correlation with plaque buildup may lead to the prediction of coronary artery disease (CAD). This work evaluates two techniques to measure bifurcation angles in 3D space using coronary computed tomography angiography (CCTA). Materials and Methods: Nine phantoms were fabricated with different bifurcation angles ranging from 55.3° to 134.5°. General X-ray and CCTA were employed to acquire 2D and 3D images of the bifurcation phantoms, respectively. Multiplanar reformation (MPR) and volume rendering technique (VRT) were used to measure the bifurcation angle between the left anterior descending (LAD) and left circumflex arteries (LCx). The measured angles were compared with the true values to determine the accuracy of each measurement technique. Inter-observer variability was evaluated. The two techniques were further applied on 50 clinical CCTA cases to verify its clinical value. Results: In the phantom setting, the mean absolute differences calculated between the true and measured angles by MPR and VRT were 2.4° ± 2.2° and 3.8° ± 2.9° respectively. Strong correlation was found between the true and measured bifurcation angles. Furthermore, no significant differences were found between the bifurcation angles measured using either technique. In clinical settings, large difference of 12.0° ± 10.6° was found between the two techniques. Conclusion: In the phantom setting, both techniques demonstrated a significant correlation to the true bifurcation angle. Despite the lack of agreement of the two techniques in the clinical context, our findings in phantoms suggest that MPR should be preferred to VRT for the measurement of coronary bifurcation angle by CCTA.

Item Type: Article
Funders: High Impact Research (HIR) (UM.C/625/1/HIR/MOHE/MED/36) and PPP grant (PO015-2015B & PO029-2015B) from the University of Malaya
Uncontrolled Keywords: Atherosclerosis; Coronary artery disease; Bifurcation angle; Coronary CT angiography
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 21 Aug 2019 07:27
Last Modified: 03 Jan 2020 04:09

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