Advances in quantitative coronary and vascular angiography

Abstract

The main objective of this thesis is to develop new, accurate and reproducible automated methods for the detection and quantification of lesions in coronary and peripheral X-ray angiograms, which make it possible to extend the straight segment analysis to analyses of sidebranches and bifurcations. We introduce new methods for the detection of pathlines (Wavepath), the detection of arterial contours (Wavecontour) and the measurement of diameter sizes in straight segments, sidebranches and bifurcations. These methods are designed to increase reproducibility and decrease the influence of user interaction. These new methods are validated extensively in coronary and vascular angiograms, proving their accuracy and reproducibility. Furthermore we developed two new bifurcation models (Y-shape and T-shape) in order to accurately measure the diameters and lesion parameters of an entire bifurcation. The models, including their edge segment analyses, are validated extensively in a clinical validation study in order to assess the inter- and intra-observer variability on pre- and post-intervention data. Overall we can conclude that our goal of improving the QCA analysis and extend it towards the new morphologies and new intervention techniques has been met.