Alexander Broersen

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  • 1. 3D fusion of coronary CT angiography with IVUS images for comparing quantitative analyses A. Broersen Division of Image Processing (LKEB) Department of Radiology Leiden University Medical Center
  • 2. Introduction source: Wikipedia
  • 3. Introduction
    • Atherosclerotic coronary artery disease
      • plaque development / calcified components
      • stenosis / ulceration / rupture / thrombus
    • Measurements within:
      • computed tomography angiography (CTA)
      • intravascular ultrasound (IVUS)
    • (Semi-)Automatic quantification:
      • improve diagnostic accuracy
      • reduce observer variability
  • 4. Multi-Slice CT Angiography
    • fast, minimally invasive imaging
    • 3D anatomical view
    • complete coronary tree
    • lumen detection
    • calcification detection
  • 5. CTA vessel analysis
    • path-line detection
    • extract longitudinal and transversal slices
    • lumen detection
    • automatic quantification:
      • stenosis
    1. 2. 3. 4.
  • 6. Restrictions without vessel wall contours
    • plaque burden
    • vessel remodeling
    • plaque eccentricity
    eccentric concentric proximal distal
  • 7. Intravascular Ultrasound
    • considered ‘Gold Standard’
    • invasive imaging
    • 2D cross-sectional view
    • single vessel
    • high resolution lumen detection
    • high resolution vessel wall detection
    catheter acquisition circular image artery
  • 8. IVUS vessel analysis
    • create a straight pseudo 3D reconstruction
    • longitudinal detection lumen / vessel wall contours
    • transversal detection lumen / vessel wall contours
    • automatic quantification:
      • stenosis
      • plaque burden
      • remodeling index
    1. 2. 3.
  • 9. Approach
    • Goals on coronary CTA data :
    • improve lumen detection
    • create and validate vessel wall detection
    • quantitatively extract parameters using the vessel wall
    • Fuse IVUS images with CTA data, for verification of quantifications and comparison of analyses
  • 10. Method
    • Acquisition
    • Contouring
    • Mapping
    • Registration
    • Quantification
    • Create generic modules in MeVisLab : environment for medical image processing & visualization
    “ Coronary CT angiography: IVUS image fusion for quantitative plaque and stenosis analyses, Marquering, H.A.; Dijkstra, J.; Besnehard, Q.J.A.; Duthé, J.P.M.; Schuijf, J.D.; Bax, J.J. & Reiber, J.H.C., Medical Imaging: Visualization, Image-guided Procedures, and Modeling, 2008 ”
  • 11. 3. Mapping
    • Landmarks:
    • bifurcations
    • calcifications
    • Pitfalls:
    • cardiac motion causes sections to repeat themselves
    • no constant pullback speed
  • 12. 4. Registration
    • Landmarks:
    • bifurcations
    • surrounding tissue
    • Pitfalls:
    • cardiac motion causes rotations / displacement catheter
    • blooming effects in CTA at calcified spots
  • 13. 5. Quantitative measurements
    • Lumen defines:
    • stenosis
    • Lumen and vessel wall define:
    • plaque burden
    • plaque eccentricity
    • remodeling index
    • Measurements are obtained of both CTA and IVUS contours
  • 14. Comparisons - CTA lumen - CTA vessel - IVUS lumen - IVUS vessel
  • 15. Example mapping in MeVisLab
  • 16. Summary
    • With a complete fusion between CTA and IVUS we can:
    • validate all CTA lumen and vessel wall contours
    • compare results of both quantitative analyses
    • extract more information from CTA
    • more insight into characteristics of IVUS images
  • 17. Acknowledgements
    • LKEB
    • M. Frenay
    • P. Kitslaar
    • Dr. J. Dijkstra
    • Dr. B. Stoel
    • Prof. H.J.C. Reiber
    • (former members)
    • Dr. H.A. Marquering
    • Dr. E. Oost
    • LUMC – Dept. Cardiology
    • J.M.J. Boogers
    • J.E. van Velzen
    • F.R. de Graaf
    • Dr. J.D. Schuijf
    • Prof. E.E. van der Wall
    • Prof. J.J. Bax