RT Journal Article
SR Electronic
T1 Parametric Color Coding of Digital Subtraction Angiography
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 919
OP 924
DO 10.3174/ajnr.A2020
VO 31
IS 5
A1 C.M. Strother
A1 F. Bender
A1 Y. Deuerling-Zheng
A1 K. Royalty
A1 K.A. Pulfer
A1 J. Baumgart
A1 M. Zellerhoff
A1 B. Aagaard-Kienitz
A1 D.B. Niemann
A1 M.L. Lindstrom
YR 2010
UL http://www.ajnr.org/content/31/5/919.abstract
AB BACKGROUND AND PURPOSE: Color has been shown to facilitate both visual search and recognition tasks. It was our purpose to examine the impact of a color-coding algorithm on the interpretation of 2D-DSA acquisitions by experienced and inexperienced observers. MATERIALS AND METHODS: Twenty-six 2D-DSA acquisitions obtained as part of routine clinical care from subjects with a variety of cerebrovascular disease processes were selected from an internal data base so as to include a variety of disease states (aneurysms, AVMs, fistulas, stenosis, occlusions, dissections, and tumors). Three experienced and 3 less experienced observers were each shown the acquisitions on a prerelease version of a commercially available double-monitor workstation (XWP, Siemens Healthcare). Acquisitions were presented first as a subtracted image series and then as a single composite color-coded image of the entire acquisition. Observers were then asked a series of questions designed to assess the value of the color-coded images for the following purposes: 1) to enhance their ability to make a diagnosis, 2) to have confidence in their diagnosis, 3) to plan a treatment, and 4) to judge the effect of a treatment. The results were analyzed by using 1-sample Wilcoxon tests. RESULTS: Color-coded images enhanced the ease of evaluating treatment success in >40% of cases (P < .0001). They also had a statistically significant impact on treatment planning, making planning easier in >20% of the cases (P = .0069). In >20% of the examples, color-coding made diagnosis and treatment planning easier for all readers (P < .0001). Color-coding also increased the confidence of diagnosis compared with the use of DSA alone (P = .056). The impact of this was greater for the naïve readers than for the expert readers. CONCLUSIONS: At no additional cost in x-ray dose or contrast medium, color-coding of DSA enhanced the conspicuity of findings on DSA images. It was particularly useful in situations in which there was a complex flow pattern and in evaluation of pre- and posttreatment acquisitions. Its full potential remains to be defined. APanteroposteriorAVFarteriovenous fistulaAVMarteriovenous malformationDSAdigital subtraction angiographyHSVhue, saturation, valueImaskpixel intensity in the mask frameImaxmaximal enhancementIpeakpeak pixel intensityTTPtime to peak