Visual and Quantitative Computerized Assessment of Disease Severity on Peripheral Angiograms

This study was designed to determine and compare the intra- and interobserver variability of visual and computerized assessment of peripheral arterial disease (PAD) severity from lower extremity angiograms, and to correlate quantitative angiographic measures with clinical predictors of PAD. Peripheral angiograms of 13 segments from the ilio-femoral-popliteal system were evaluated on two separate occasions by nine radiologists and with a quantitative computerized method. In a separate study, images from 18 patients undergoing diagnostic lower extremity angiography were analyzed with use of quantitative angiography and the results were compared with clinical and lipid risk factors. The data demonstrate that computerized assessment of peripheral angiograms is associated with lower intra- and interobserver variability than visual assessment of the same films. Despite this, there was excellent intraobserver and good interobserver agreement on the presence or absence of a severe lesion with visual assessment. Quantitative computerized measures of disease severity correlate with several known predictors of large vessel PAD. Computerized assessment of peripheral angiograms may be a useful tool in the clinical and investigational evaluation of PAD.