JHC Reiber

Johan H. C. Reiber

English

PubMed

Reiber, J.H.C.

Leiden University Scholary Publications

Introduction to QCA, IVUS and OCT in interventional cardiology

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EDITORIAL NOTE
Introduction to QCA, IVUS and OCT in interventional
cardiology
Johan H. C. Reiber
Received: 10 January 2011 / Accepted: 13 January 2011 / Published online: 20 February 2011
 The Author(s) 2011. This article is published with open access at Springerlink.com
It is with great pleasure and honor for me to introduce
this topical issue on QCA, IVUS and OCT. QCA has
come a long way, from the early 1980s with the
angiograms being acquired on 35 mm cinefilm and
requiring very expensive cinefilm projectors with
optimal zooming for the quantitative analysis [1], to
modern complete digital imaging with the images
acquired at resolutions of 5122 or 1,0242 pixels, and
with the image data widely available throughout the
hospital by means of cardiovascular PACS systems.
Major differences were of course that on cinefilm the
coronary arteries were displayed as bright arteries on
a darker background, and there was always an
associated pincushion distortion caused by the con-
cave input screen of the image intensifier. With the
digital systems the arteries are now displayed as dark
vessels on a bright background and the modern flat
panel X-ray detectors are free from geometric
distortions. Although there have been many years of
debate about the resolution of cinefilm versus digital,
the higher contrast resolution of the digital approach
has compensated much of the higher spatial resolu-
tion of the 35 mm cinefilm, and thus digital has
been completly accepted. Also, extensive validation
studies have not proven major differences in accuracy
and precision between cinefilm and digital: the
variability in the analysis is for both in the order of
about  pixel, or 0.11 mm [2, 3].
For many years, quantitative coronary arteriogra-
phy (QCA) has been used in clinical research in the
hospitals and in core laboratories to assess regression
and progression of coronary obstructions in pharma-
cological interventions, to assess the efficacy of
coronary interventions after the introduction of PTCA
and stenting by bare-metal (BMS), drug-eluting (DES)
and presently biodegradable stents, and of course for
vessel sizing. In all these cases, the analyses were done
on straight vessels. New developments have been
directed at bifurcation stenting and the associated
QCA, and on 3D QCA and registration with IVUS/
OCT. These new issues are elegantly described in the
section guest edited by Ricardo A. Costa.
It has been well recognized for many years that
despite the wide availability of the angiogram and the
QCA, an angiogram is only a lumenogram, and that
the disease is in the vessel wall. For proper decision
making purposes, the interventionalist must know
what the composition is of the plaque. This was made
possible with intravascular ultrasound, but with the
recent advent of Virtual Histology and the iMAP,
even more information has become available, which
has revived the field of intravascular ultrasound. In
this issue, all the possibilities, limitations and appli-
cations of IVUS in interventional cardiology are
clearly described in the papers selected by guest
J. H. C. Reiber (&)
Division of Image Processing (LKEB), Department
of Radiology, Leiden University Medical Center,
Leiden, The Netherlands
e-mail: J.H.C.Reiber@lumc.nl
123
Int J Cardiovasc Imaging (2011) 27:153–154
DOI 10.1007/s10554-011-9808-3
editor Hector M. Garcia-Garcia. Likewise, optical
coherence tomography is now playing a major role in
interventional cardiology and great papers have been
selected by guest editor Hiram G. Bezerra.
With this special issue on QCA, IVUS and OCT
we have assembled timely contributions from leading
experts in these fields. All of these developments and
their work play a major role in modern interventional
cardiology. I wish our readership much pleasure with
this special issue.
Open Access This article is distributed under the terms of the
Creative Commons Attribution Noncommercial License which
permits any noncommercial use, distribution, and reproduction
in any medium, provided the original author(s) and source are
credited.
References
1. Reiber JHC, Serruys PW, Kooijman CJ, Wijns W, Slager CJ,
Gerbrands JJ, Schuurbiers JCH, den Boer A, Hugenholtz PG
(1985) Assessment of short-, medium-, and long-term varia-
tions in arterial dimensions from computer-assisted quanti-
tation of coronary cineangiograms. Circulation 71:280–288
2. Reiber JHC, van der Zwet PM, Koning G, von Land CD,
van Meurs B, Gerbrands JJ, Buis B, van Voorthuisen AE
(1993) Accuracy and precision of quantitative digital coro-
nary arteriography: observer-, short-, and medium-term
variabilities. Cathet Cardiovasc Diagn 28(3):187–198
3. Reiber JHC, Tuinenburg JC, Koning G, Jansen JP, Rares A,
Lansky AJ, Goedhart B (2009) Quantitative coronary arte-
riography. In: Oudkerk M, Reiser MF (eds) Coronary radi-
ology, 2nd revised edn [Series: medical radiology, sub
series: diagnostic imaging, Baert AL, Knauth M, Sartor K
(eds)] , Springer, Heidelberg, pp 41–65
154 Int J Cardiovasc Imaging (2011) 27:153–154
123


Accuracy and precision of quantitative digital coronary arteriography: observer-, short-, and medium-term variabilities.

Assessment of short-, medium-, and long-term variations in arterial dimensions from computer-assisted quantitation of coronary cineangiograms.

Quantitative coronary arteriography. In: Oudkerk M, Reiser MF (eds) Coronary radiology, 2nd revised edn [Series: medical radiology, sub series: diagnostic imaging,

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Introduction to QCA, IVUS and OCT in interventional cardiology

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