Lossy JPEG compression in quantitative angiography: the role of X-ray quantum noise.

In medical imaging, contrary to applications in the consumer market, the use of irreversible or lossy compression is still in its beginnings. This is due to the suspected risk of compromising the diagnostic content. Many studies have been performed, but it was not until 2008 that national activities in different countries resulted in recommendations for the safe use of irreversible image compression in clinical practice. Quantitative coronary angiography (QCA), however, poses a special problem, since here a large variation in published maximum compression factors has strengthened the general concerns about the use of lossy techniques. Up to now, the reason for the variation has not been thoroughly investigated. Reasons for the discrepancies in published compression factors are determined in this study. Since JPEG compression reduces the quantum noise of the X-ray images, the impact of compression is overestimated when interpreting any change in local diameter as an error. By taking into consideration the quantitative effect of quantum noise in QCA, it is shown that the influence of JPEG compression can be neglected for compression factors up to ten at clinically applicable X-ray doses. This limit is comparable to that found by visual analysis for aesthetic image quality. Future studies on image compression effects should take the interaction with quantum noise explicitly into consideration.

Impact of vessel curvature on the accuracy of three-dimensional intravascular ultrasound: validation by phantoms and coronary segments.

BACKGROUND: Three-dimensional intravascular ultrasound (IVUS) is used for volumetric assessment of arteriosclerotic plaque burden and restenotic tissue at follow-up after coronary interventions. However, the accuracy of these measurements, especially in tortuous vessels, is unclear. METHODS: A commercially available electrocardiogram (ECG)-gated 3-dimensional-IVUS system was tested in volume-validated straight and curved hydrocolloid phantoms and in volume-validated coronary specimens. Catheter withdrawal (30 MHz, 3.2F) was triggered using standardized ECG source with 0.2-mm step intervals per cardiac cycle simulation. RESULTS: On the basis of automated phantom volume measurements, IVUS overestimated true phantom volume (relative error = [measured V - true V]/true V x 100) by a median of 0.9%, 0.25%, and 1.96% for straight, mildly curved, and severely curved segments, respectively. The true volume of the coronary specimens was overestimated by a median of 5.79%. CONCLUSION: A median percentage deviation of 3-dimensional-IVUS-measured volumes from the true volumes of less than 10% in phantoms and coronary artery segments can be achieved.

Discrimination of early/intermediate and advanced/complicated coronary plaque types by radiofrequency intravascular ultrasound analysis.

Radiofrequency intravascular ultrasound (IVUS-RF) analysis, as an extension of conventional IVUS imaging, may provide more accurate plaque discrimination. Thirty-two autopsy atherosclerotic coronary arteries were investigated. Corresponding sectors in different plaques were matched by histologic and RF analysis. Histologic analysis utilized the American Heart Association plaque classification. The backscattered ultrasound RF signal was analyzed by fast-Fourier transform, providing the underlying frequency components of its power spectrum. The normalized backscattered signal power (in decibels [dB]) for frequencies between 15.3 and 40.3 MHz was then measured for plaque discrimination. Advanced/complicated plaque types showed a higher signal power at all frequencies than early/intermediate lesion types (p <0.001 to p = 0.005). Discrimination of advanced/complicated lesion types was best at 15.3 MHz, with a cut-off point of 2.5 dB (sensitivity 93%, specificity 79%), and second best at 17.6 MHz (sensitivity 87%, specificity 71%, cut-off point 1.9 dB). With conventional IVUS, plaque discrimination was weaker; the best sensitivity for diagnosing early/intermediate lesion types was reached for "soft plaque" (sensitivity 63%, specificity 73%). Compared with conventional IVUS, IVUS-RF can discriminate between advanced/complicated and early/intermediate coronary atherosclerotic lesions with relatively high sensitivity and specificity in vitro.