AJDRAJNR - American Journal of Neuroradiology

Published ahead of print on November 27, 2008
doi: 10.3174/ajnr.A1381
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American Journal of Neuroradiology 30:459-461, March 2009
© 2009 American Society of Neuroradiology

Research Perspectives

Dangerous Advances in Measurements from Digital Subtraction Angiography: When Is a Millimeter Not a Millimeter?

A.J. Foxa, J. Millarb, J. Raymondc, J.C. Pryord, D. Royc, G.A. Tomlinsone, J.P. McKaya and A.J. Molyneuxf

a Department of Neuroradiology, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada
b Department of Neuroradiology, Wessex Neurological Centre, Southampton General Hospital, Southampton, UK
c Department of Neuroradiology, Hôpital Notre Dame, Université de Montréal, Montréal, Ontario, Canada
d Department of Interventional Neuroradiology and Endovascular Neurosurgery, Massachusetts General Hospital, Harvard University, Boston, Mass
e Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada
f Oxford Neurovascular and Neuroradiology Research Unit (ONNRU), University of Oxford, Oxford, UK

Please address correspondence to Allan J. Fox, MD, Sunnybrook Heath Sciences Centre, 2075 Bayview Ave, Room AG31b, Toronto, ON, M4N 3M5, Canada; e-mail: allan.fox{at}sunnybrook.ca

SUMMARY: Aneurysms need accurate millimeters (mm). Direct millimeters were lost with digital subtraction angiography (DSA) years ago, with measurements in pixels. Advances in DSA can now give inherent millimeters. The Cerecyte aneurysm coiling trial's angiographic core lab assesses images from compact disc (CD). External fiducials for millimeter calibration are required. Of 25 cases with two 10 mm fiducials, near and far from the intensifier, the midline mean is between 9 "mm" to 15 "mm". Yet 10 mm must be 10 mm. This variance is potentially dangerous. Proprietary software seems to prohibit calibration transfer via CD to another vendor's system.




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Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X