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ARTICLE

American College of Cardiology/ European Society of Cardiology international study of angiographic data compression phase I

The effects of lossy data compression on recognition of diagnostic features in digital coronary angiography

Richard A. Kerensky, MD, FACC, Jack T. Cusma, PhD, Paul Kubilis, MS, R.üdiger Simon, MD, FACC^||, Thomas M. Bashore, MD, John W. Hirshfeld, Jr., MD, FACC^¶, David R. Holmes, Jr., MD, FACC, Carl J. Pepine, MD, FACC and Steven E. Nissen, MD, FACC^*

^* Cleveland Clinic Foundation, Cleveland, Ohio, USA
Duke University, Durham, North Carolina, USA
Mayo Clinic, Rochester, Minnesota, USA
University of Florida, Gainesville, Florida, USA
^|| University of Kiel, Kiel, Germany
^¶ University of Pennsylvania, Philadelphia, Pennsylvania, USA

Manuscript received June 1, 1999; accepted December 1, 1999.

Reprint requests and correspondence: Dr. Richard A. Kerensky, Section of Cardiology, University of Florida, 1600 Archer Road, P.O. Box 100277, Gainesville, Florida 32610-0277

OBJECTIVES

This study intended to determine the effect of varying degrees of lossy Joint Photographic Experts Group (JPEG) compression on detection of coronary angiographic features.

BACKGROUND

Compression of digital coronary angiograms facilitates playback of images and decreases cost. There are little data on the effect of compression on the accuracy of coronary angiography.

METHODS

At six centers, 71 angiographers each reviewed a set of 100 angiographic sequences. The 100 sequences were divided into four, 25-sequence subsets. Each subset of 25 was displayed either as original images or at one of three compression ratios (CRs) (6:1, 10:1 or 16:1). The effect of lossy compression on the sensitivity and specificity for detection of diagnostic features was determined. The effect of compression on subjective measures of image quality graded by the angiographers was also examined.

RESULTS

Lossy compression at a ratio of 16:1 decreased the sensitivity for the detection of diagnostic features (76% vs. 80% p = 0.004). The largest effect was in the detection of calcification (52% vs. 63% at 16:1 compression vs. original images, p < 0.001). Subjective indicators of image quality indicated a reduction in confidence in interpretation at CRs of 10:1 and 16:1.

CONCLUSIONS

With increased ratios of lossy compression, a degradation of digital coronary angiograms occurs that results in decreased diagnostic accuracy. The sensitivity for detection of common diagnostic features was decreased, and subjective assessment of image quality was impaired. Caution is warranted in the interpretation of coronary angiograms that have been subjected to lossy JPEG compression beyond a ratio of 6:1.

Abbreviations and Acronyms   ACC = American College of Cardiology   ANOVA = analysis of variance   CASS = Coronary Artery Surgery Study   CR = compression ratio   DICOM = Digital Imaging for Communication in Medicine   ESC = European Society of Cardiology   fps = frames per second   JPEG = Joint Photographic Experts Group   MB = megabytes

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