A Novel Recording Tool for Education and Quality Assurance in Digital Angiography

Background: A draw-back of current digital angiography systems is that diagnostic and interventional procedures cannot be completely recorded by the angiography device. In most clinical settings, however, it is desirable to be able to review the angiographic procedure in order to see what can be done better or what went wrong. Additionally, it would be convenient to be able to annotate parts of the procedure, to retrospectively select important scenes and to be able to show them to colleagues or use them in teaching medical students and residents. Evaluation: We have attached a state-of-the-art, high-speed frame grabbing device (Matrox Helios) to the high line video output of a biplane neuroangiography system (Philips Allura Xper FD20/10). Using our software, it now is possible to record complete angiographic procedures biplane either as video streams or as a sequence of images. Additional information about the patient is stored in additional XML files. By compressing the data on the fly, recording can be continuous up to 12 hours. The system also allows for retrospective annotation of the video streams, for editing and cutting out parts of the sequences as well as playing the sequences at different speeds. Discussion: With our new system, we can more easily educate students and get a better grasp at problems which might occur during an angiographic procedure. Additionally, since we plan to use the system for all interventions, it is also a valuable tool for quality assurance and legal purposes. Since editing and annotating the image or video streams does not actually modify the stream data (crop marks and annotations are saved in an XML file), it is possible to assure that the stream data has not been modified after the end of the angiographic procedure. Conclusion: Our new recording and playback system is the first step towards better teaching and quality assurance. In the future, we plan to also attach a video camera to document the neuroradiologist’s manual actions and to include links to existing PACS data.