Quantitative Comparison of Color-Coded Parametric Imaging Technologies Based on Digital
Subtraction and Digital Variance Angiography: A Retrospective Observational Study
The evaluation of hemodynamic conditions in critical limb-threatening ischemia (CLTI)
patients is inevitable in endovascular interventions. In this study, the performance
of color-coded digital subtraction angiography (ccDSA) and the recently developed
color-coded digital variance angiography (ccDVA) was compared in the assessment of
key time parameters in lower extremity interventions. The observational study included
19 CLTI patients who underwent peripheral vascular intervention at our institution
in 2020. Pre- and post-dilatational images were retrospectively processed and analyzed
by a commercially available ccDSA software (Kinepict Medical Imaging Tool 6.0.3; Kinepict
Health Ltd., Budapest, Hungary) and by the recently developed ccDVA technology. Two
protocols were applied using both a 4 and 7.5 frames per second acquisition rate.
Time-to-peak (TTP) parameters were determined in four pre- and poststenotic regions
of interest (ROI), and ccDVA values were compared to ccDSA read-outs. The ccDVA technology
provided practically the same TTP values as ccDSA (r = 0.99, R2 = 0.98, p < 0.0001).
The correlation was extremely high independently of the applied protocol or the position
of ROI; the r value was 0.99 (R2 = 0.98, p < 0.0001) in all groups. A similar correlation
was observed in the change in passage time (r = 0.98, R2 = 0.96, p < 0.0001). The
color-coded DVA technology can reproduce the same hemodynamic data as a commercially
available DSA-based software; therefore, it has the potential to be an alternative
decision-supporting tool in catheter labs.