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The accuracy of computed tomography central luminal line measurements in quantifying stent graft migration

England, A; Garcia-Finana, M; How, T; Vallabhaneni, SR; McWilliams, R

Authors

A England

M Garcia-Finana

T How

SR Vallabhaneni

R McWilliams



Abstract

Purpose
This study evaluated the accuracy of central luminal line (CLL) measurements in quantifying stent graft migration. The bias of the CLL technique together with observer variability were assessed.
Methods

Stent grafts were deployed in plastic aortic phantoms at fixed locations from two side branches. Each phantom was filled with iodinated contrast, and a 2-mm multislice computed tomography (CT) scan was performed. The stent graft was then displaced caudally, its new location determined, and again, a CT scan performed. This created a series of 15 cases with known stent graft migration. CLLs were used to measure stent graft position on the CT scans and calculate migration (3 observers). In vivo stent graft migration was then evaluated in a similar manner using a series of follow-up CT scans from nine patients (2 observers). All CLL measurements were performed independently and were repeated on a separate occasion.
Results

The mean difference in CLL migration between the actual and observed measurements (bias) in the aortic phantoms was <1 mm. The 95% confidence intervals for the bias were within the interval (−1 and 1 mm), and the 95% limits of agreement were within −3 mm and +3 mm. The 95% limits of agreement for measurements within and between observers were −4 to 2 mm and −2 to 2 mm, respectively. The phantom study generated a coefficient of repeatability (RC) of 1 mm for within-observer measurements. Clinically, CLLs generated 95% limits of agreement within and between observers of −3 to 4 mm (RC, 2 mm) and −3 to +3 mm, respectively.
Conclusions

Bias from CLL-determined migration is small and insignificant from a practical point of view. A small amount of measurement variability within and between observers does exist; it should be feasible to detect changes in stent graft position that are ≥4 mm.

Citation

England, A., Garcia-Finana, M., How, T., Vallabhaneni, S., & McWilliams, R. The accuracy of computed tomography central luminal line measurements in quantifying stent graft migration. Journal of Vascular Surgery, 55, 895-905. https://doi.org/10.1016/j.jvs.2011.10.083

Journal Article Type Article
Deposit Date Sep 6, 2013
Journal Journal of Vascular Surgery
Print ISSN 0741-5214
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 55
Pages 895-905
DOI https://doi.org/10.1016/j.jvs.2011.10.083
Publisher URL http://dx.doi.org/10.1016/j.jvs.2011.10.083
Related Public URLs http://www.jvascsurg.org/



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