Fusion of 3D QCA and IVUS/OCT.
The combination/fusion of quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS)/optical coherence tomography (OCT) depends to a great extend on the co-registration of X-ray angiography (XA) and IVUS/OCT. In this work a new and robust three-dimensional (3D) segmentation and registration approach is presented and validated. The approach starts with standard QCA of the vessel of interest in the two angiographic views (either biplane or two monoplane views). Next, the vessel of interest is reconstructed in 3D and registered with the corresponding IVUS/OCT pullback series by a distance mapping algorithm. The accuracy of the registration was retrospectively evaluated on 12 silicone phantoms with coronary stents implanted, and on 24 patients who underwent both coronary angiography and IVUS examinations of the left anterior descending artery. Stent borders or sidebranches were used as markers for the validation. While the most proximal marker was set as the baseline position for the distance mapping algorithm, the subsequent markers were used to evaluate the registration error. The correlation between the registration error and the distance from the evaluated marker to the baseline position was analyzed. The XA-IVUS registration error for the 12 phantoms was 0.03 ± 0.32 mm (P = 0.75). One OCT pullback series was excluded from the phantom study, since it did not cover the distal stent border. The XA-OCT registration error for the remaining 11 phantoms was 0.05 ± 0.25 mm (P = 0.49). For the in vivo validation, two patients were excluded due to insufficient image quality for the analysis. In total 78 sidebranches were identified from the remaining 22 patients and the registration error was evaluated on 56 markers. The registration error was 0.03 ± 0.45 mm (P = 0.67). The error was not correlated to the distance between the evaluated marker and the baseline position (P = 0.73). In conclusion, the new XA-IVUS/OCT co-registration approach is a straightforward and reliable solution to combine X-ray angiography and IVUS/OCT imaging for the assessment of the extent of coronary artery disease. It provides the interventional cardiologist with detailed information about vessel size and plaque size at every position along the vessel of interest, making this a suitable tool during the actual intervention.
Division of Image Processing, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands. S.T.Tu@lumc.nl
Shengxian
S
Tu
Niels R
NR
Holm
Gerhard
G
Koning
Zheng
Z
Huang
Johan H C
JH
Reiber
D000368:Aged; D000465:Algorithms; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D002681:China; D017023:Coronary Angiography / Q000295:instrumentation; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D019047:Phantoms, Imaging; D011237:Predictive Value of Tests; D011379:Prognosis; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D041623:Tomography, Optical Coherence / Q000295:instrumentation; D018084:Ultrasonography, Interventional / Q000295:instrumentation
Int J Cardiovasc Imaging. 2007 Dec;23(6):733-8
17370139
N Engl J Med. 2004 Jan 15;350(3):221-31
14724301
EuroIntervention. 2008 Aug;4(2):285-91
19110796
Catheter Cardiovasc Interv. 2007 Feb 1;69(2):172-80
17191235
Catheter Cardiovasc Interv. 2005 Apr;64(4):451-9
15744720
Invest Radiol. 2005 Aug;40(8):514-20
16024989
N Engl J Med. 2007 Mar 8;356(10):998-1008
17296824
Am J Cardiol. 2008 Jun 15;101(12):1704-11
18549844
Int J Cardiovasc Imaging. 2010 Jan;26(1):5-17
19763876
Catheter Cardiovasc Interv. 2001 Mar;52(3):334-41
11246248
Med Image Anal. 2006 Aug;10(4):615-31
16644262
Int J Cardiovasc Imaging. 2009 Mar;25(3):223-8
19034686
IEEE Trans Med Imaging. 1995;14(2):230-41
18215826
J Am Coll Cardiol. 2005 Apr 5;45(7):995-8
15808753
Cathet Cardiovasc Diagn. 1998 Mar;43(3):254-60
9535359
N Engl J Med. 2003 Oct 2;349(14):1315-23
14523139
Catheter Cardiovasc Interv. 2007 Mar 1;69(4):479-82
17192961
Catheter Cardiovasc Interv. 2010 Aug 1;76(2):291-8
20665880
EuroIntervention. 2009 May;5(1):127-32
19577994
Catheter Cardiovasc Interv. 2009 Apr 1;73(5):620-6
19309696
Cathet Cardiovasc Diagn. 1993 Mar;28(3):187-98
8439993
Circulation. 1977 Feb;55(2):329-37
832350
N Engl J Med. 1987 May 28;316(22):1371-5
3574413
Circ J. 2009 Oct;73(10):1841-7
19644218
Circulation. 2000 Aug 1;102(5):511-6
10920062
J Endovasc Surg. 1998 May;5(2):126-33
9633956
Circulation. 1985 Feb;71(2):280-8
3965172
Int J Cardiovasc Imaging. 2009 Oct;25(7):657-67
19633999
IEEE Trans Med Imaging. 2002 Jul;21(7):724-40
12374311