Accurate BF measurements can be made with motion-immune DE DSA. The BF measurements can be completed before the onset of significant changes in BF due to contrast injection. Furthermore, it is possible to make the BF measurements during routine coronary arteriography.

The problems associated with visual interpretation of coronary arteriograms have been well-documented. There is a need for more physiologic means of assessing coronary artery stenosis during routine coronary arteriography. Volumetric coronary blood flow assessed as a function of time can be a valuable aid in the analysis of functional significance of arterial obstruction. A volumetric coronary blood flow measurement technique was investigated in a swine animal model using phase matched temporal subtraction images. The left anterior descending (LAD) coronary artery of swine animal models were instrumented with an ultrasound flow probe (US) and a vascular occluder producing stenosis. Contrast material injections (2-4 ml/sec for 3 sec) were made into the left coronary ostium during image acquisition. Phase-matched temporal subtraction (DSA) images were used to measure volumetric coronary blood flow in the LAD. In addition, a technique for automatic estimation of iodine calibration slope was also investigated. In 49 independent comparisons, the mean coronary blood flow (FPA) correlated extremely well with the mean US flow (FPA = 0.92US + 1.42 ml/min, r = 0.99, standard error of estimate (SEE) = 4.32 ml/min). Further more, the automatic iodine calibration technique was shown to be very accurate. In conclusion, accurate volumetric coronary blood flow measurements can be made before the onset of significant changes in coronary blood flow due to contrast injection.

An area beam equalization technique has been investigated in order to generate patient-specific compensating filters for digital angiography. An initial image was used to generate the compensating filter, which was fabricated using a deformable compensating material, containing CeO2, and an array of square pistons. The CeO2 attenuator thicknesses were calculated using the gray level information from the initial unequalized image. The array of pistons was pressed against a uniform thickness of attenuating material to generate a filter for x-ray beam equalization. The filter was subsequently inserted into the x-ray beam for the final equalized radiograph. It was positioned close to the focal spot (magnification of 8.0) in order to minimize edge artifacts from the filter. The equalization of x-ray transmission across the field exiting from the object significantly improved the image quality by preserving local contrast throughout the image. The contrast-to-noise ratio (CNR) in the equalized images was increased-by up to fivefold. Phantom studies indicate that equalized images using a relatively small array of pistons (e.g., 8 x 8) produce significant improvement in image quality with negligible perceptible artifacts. Animal studies showed that beam equalization significantly improved fluoroscopic and angiographic image quality. X-ray beam equalization produced an image with a relatively uniform scatter-glare intensity and it reduced the scatter-glare fraction in the previously underpenetrated region of the image from 0.65 to 0.50. Also, x-ray tube loading due to the mask assembly itself was negligible. In conclusion, area beam equalization reduces the scatter-glare fraction and significantly improves CNR in the previously underpenetrated region of the image.

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