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Perceptual assessment of multiple stent deployment

Evaluating the placement of multiple coronary stents requires fine judgments of distance between two or more deployed stents in order to determine if there is continuous coverage without a gap or overlap between the two. These judgments are made difficult by limited system resolution, noise, relatively low contrast of the deployed stent, and stent motion during the cardiac cycle. In this work, we assess the effect of frame rate and number of frames used in a sequence on the detection accuracy of gaps between the stents. Both of these factors can be used to reduce patient dose. We use real X-ray coronary angiograms as backgrounds along with stents imaged separately with Lucite for similar beam attenuation. Stents and simulated guidewires are embedded in the angiograms by adding optical densities after scatter subtraction. Realistic motion is rendered by manually synchronizing the stent densities to vascular features in each image. We find no significant difference the different frame rates or sequence lengths, indicating potential savings in dose.