人工智能增强光学相干断层扫描软件对经皮冠状动脉介入治疗决策的影响

Journal of the Society for Cardiovascular Angiography & Interventions Pub Date : 2025-03-01 DOI:10.1016/j.jscai.2024.102438

Matthew Sibbald MD, PhD , Haley R. Mitchell BS , Jana Buccola MS , Natalia Pinilla-Echeverri MD, PhD

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引用次数: 0

摘要

背景：将血管内成像整合到经皮冠状动脉介入治疗（PCI）工作流程中需要医生的时间和专业知识。人工智能（AI）软件可以自动识别关键的血管内成像参数，有可能简化医生的工作流程，提高准确性，并减少PCI计划决策的可变性。本研究调查了人工智能软件Ultreon（雅培）与传统软件AptiVue（雅培）相比，在基于光学相干断层扫描（OCT）的PCI计划中，是否提高了医生决策的准确性、可变性和效率。方法在这项多病例研究中，30名具有不同OCT成像经验的介入心脏病专家使用Ultreon和AptiVue平台评估了21例pci前OCT回拉。医师对病变形态、长度和直径的PCI计划决策与已发表的最佳实践进行比较。使用统计模型评估决策准确性、可变性和时间效率。结果与AptiVue相比，使用Ultreon的医生基于oct的计划决策在钙严重程度的识别上更准确，准确率为1.77 (95% CI, 1.27-2.50；P & lt;.001)，血管准备策略降低2.00 (95% CI, 1.12-3.4；P = 0.018)，支架直径增加2.83 (95% CI, 1.79-4.50；P & lt;措施)。医生在使用Ultreon进行评估时表现出较少的可变性，特别是对于远端和近端支架着陆区，以及计划的支架长度(P <；。)。Ultreon提高了OCT评估的效率，使OCT评估时间缩短了0.5分钟(P <；。)。无论医生之前的OCT经验如何，都可以观察到这些益处。结论使用人工智能增强的Ultreon软件，医生基于oct的PCI计划决策更准确，变化更少，效率更高。这可能有助于在PCI工作流程中更充分地采用血管内成像。

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Impact of Artificial Intelligence-Enhanced Optical Coherence Tomography Software on Percutaneous Coronary Intervention Decisions

Background

Integration of intravascular imaging into percutaneous coronary intervention (PCI) workflow demands physician time and expertise. Artificial intelligence (AI)-enabled software that automates the identification of key intravascular imaging parameters has the potential to streamline physician workflow, increase accuracy, and reduce variability in PCI planning decisions. This study investigated if AI-enabled software, Ultreon (Abbott), compared with traditional software, AptiVue (Abbott), improved physician decision-making accuracy, variability, and efficiency in optical coherence tomography (OCT)-based PCI planning.

Methods

In this multireader, multicase study, 30 interventional cardiologists of varying OCT imaging experience evaluated 21 pre-PCI OCT pullbacks using both Ultreon and AptiVue platforms. Physician PCI planning decisions about lesion morphology, length, and diameter were compared to published best practices. Decision accuracy, variability, and time efficiency were assessed using statistical models.

Results

Physician OCT-based planning decisions were more accurate using Ultreon compared to AptiVue in the identification of calcium severity by 1.77 (95% CI, 1.27-2.50; P < .001), vessel preparation strategy by 2.00 (95% CI, 1.12-3.4; P = .018), and stent diameter by 2.83 (95% CI, 1.79-4.50; P < .001). Physicians exhibited less variability in assessments using Ultreon, especially for distal and proximal stent landing zone, and planned stent length (P < .0001). The efficiency of OCT assessments was improved with Ultreon, reducing the duration of OCT assessments by 0.5 minutes (P < .0001). The benefits were observed irrespective of the physician’s prior OCT experience.

Conclusions

Physician OCT-based PCI planning decisions were more accurate, less variable, and more efficient with AI-enhanced Ultreon software. This could potentially aid in the fuller adoption of intravascular imaging in PCI workflow.

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来源期刊

Journal of the Society for Cardiovascular Angiography & Interventions Cardiology and Cardiovascular Medicine

CiteScore

1.40

自引率

0.00%

发文量

审稿时长

48 days