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AJNR - American Journal of Neuroradiology

Publication Preview: Published November 27, 2008

American Journal of Neuroradiology 2009;30:459.

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American Journal of Neuroradiology
DOI 10.3174/ajnr.A1381

RESEARCH PERSPECTIVES

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

A.J. Fox, J. Millar, J. Raymond, J.C. Pryor, D. Roy, G.A. Tomlinson, J.P. McKay and A.J. Molyneux

From the Department of Neuroradiology (A.J.F., J.P.M.), Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada; Department of Neuroradiology (J.M.), Wessex Neurological Centre, Southampton General Hospital, Southampton, UK; Department of Neuroradiology (J.R., D.R.), Hôpital Notre Dame, Université de Montréal, Montréal, Ontario, Canada; Department of Interventional Neuroradiology and Endovascular Neurosurgery (J.C.P.), Massachusetts General Hospital, Harvard University, Boston, Mass; Department of Public Health Sciences (G.A.T.), University of Toronto, Toronto, Ontario, Canada; and Oxford Neurovascular and Neuroradiology Research Unit (ONNRU) (A.J.M.), 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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