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Imaging plaque inflammation crt

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Imaging plaque inflammation crt

  1. 1. Ritman et al.
  2. 2. Ritman et al.
  3. 3. Ritman et al.
  4. 4. Ritman et al.
  5. 5. Virmani et al.
  6. 6. Update on Image Analysis of Ultimate IVUS Preliminary Case Studies
  7. 7. Ultimate IVUS Vasa Vasaorum Image Analysis CASE No 1
  8. 8. Dataset Summary: 031204 • Frame count: 1,073 • Sampling: 10 frames/second • Key frames: – 000: Start of dataset (SOD) – 006: Suggested SOD (SSOD) for processing purposes – 404: Contrast agent (CA) first detected in lumen – 417: CA at a minimum – 418-450: partial washout – 452-490: Complete washout – ~530: CA reaches apparent minimum – 1044: Suggested end of dataset (SEOD) – 1046: Catheter starting to be removed – 1072: End of dataset (EOD)
  9. 9. Dataset: 031204
  10. 10. Differential Enhancement: 031204 Post-injection (Frame #800) Peak Injection (Frame #600) Pre-injection (Frame #200) Lumen subtracted (microbubble shadow effect is not calculated) The enhancement lasts for at least 25 seconds. Background motions are cancelled Microbubble Enhanced IVUS Imaging of Plaque Inflammation
  11. 11. Dataset: 031204 IVUS Movie of Only Microbubble Enhanced Spots
  12. 12. Range of Enhancement
  13. 13. Differential Enhancement: 031204 Post-injection (Frame #800) Peak Injection (Frame #600) Ultimate IVUS Vasa Vasorum Imaging – Template 1
  14. 14. Differential Enhancement: 031204Peak Injection (Frame #600) Post-injection (Frame #800) Ultimate IVUS Vasa Vasorum Imaging – Template 2
  15. 15. Differential Enhancement: 031204 Post-injection (Frame #800) Peak Injection (Frame #600) Ultimate IVUS Vasa Vasorum Imaging – Template 3
  16. 16. Expected Correlation with the Anatomy of Vasa Vasorum Note: Pathology pictures are not related to IVUS (Pathology taken from Ritman et al.)
  17. 17. Average Enhancement: 031204 Intimo-Medial and Plaque Area Adventitia Area 10 Frames per Second Quantitative Monitoring of Plaque Perfusion
  18. 18. Average Enhancement: 031204 Intimo-Medial and Plaque Area Adventitia Area Quantitative Monitoring of Plaque Perfusion
  19. 19. Ultimate IVUS Image Analysis of CASE No 2
  20. 20. Dataset Summary: 040116 • Frame count: 9,000 • Sampling: 10 frames/second • Keyframes: – 0001: Start of dataset – 1797: Contrast agent detected in lumen (first injection) – 2609: Contrast agent detected in lumen (washout) – 9000: End of dataset
  21. 21. Dataset: 040116 Please wait for 30 sec! Injection: Frames #1700-1800
  22. 22. Pre-injection (Frame #388) Peak Injection (Frame #2837) Post-injection (Frame #5308) Differential Enhancement: 040116 Real time Visualization
  23. 23. Differential Enhancement: 040116 Post InjectionPeak Injection Ultimate IVUS Vasa Vasorum Imaging – Template 1
  24. 24. Differential Enhancement: 040116 Post InjectionPeak Injection Plaque and Intimo-Medial Area Enhancement: 2.5% Adventitia Enhancement: 2.7% Ultimate IVUS Vasa Vasorum Imaging – Template 2
  25. 25. Differential Enhancement: 040116 Post InjectionPeak Injection Ultimate IVUS Vasa Vasorum Imaging– Template 3
  26. 26. Average Enhancement: 040116 pushing contrast with saline injection in the guiding catheter First Injection Second Injection Post-Injection Shadow effect Intimo-Medial and Plaque Area Adventitia Area Quantitative Monitoring of Plaque Perfusion
  27. 27. Average Enhancement: 040116 Pushing contrast with saline injection in the guiding catheter First Injection Second Injection Baseline Post-Injection Shadow effect Intimo-Medial and Plaque Area Adventitia Area Quantitative Monitoring of Plaque Perfusion
  28. 28. Ultimate IVUS Image Analysis of CASE No 3
  29. 29. Dataset Summary: 115768 • Frame count (Loop 6): 1,096 • Sampling: 30 frames/second • Key frames: – 0000: Start of dataset (SOD) – 0086: Contrast agent (CA) first detected in lumen – 1096: End of dataset (EOD)
  30. 30. Dataset: 115768
  31. 31. Differential Enhancement: 115768 Pre-injection (Frame #752, Loop 4) After peak (Frame #445, Loop 6) Post-injection (Frame #815, Loop 6) Real time Visualization
  32. 32. Differential Enhancement: 115768After peak in lumen (Frame #445, Loop 6) Post-injection (Frame #815, Loop 6) Ultimate IVUS Vasa Vasorum Imaging– Template 1
  33. 33. Differential Enhancement: 115768Peak Injection (Frame #445, Loop 6) Post-injection (Frame #815, Loop 6) Ultimate IVUS Vasa Vasorum Imaging – Template 2
  34. 34. Differential Enhancement: 115768Peak Injection (Frame #445, Loop 6) Post-injection (Frame #815, Loop 6) Ultimate IVUS Vasa Vasorum Imaging– Template 3
  35. 35. Average Enhancement: 115768 Lumen Flow Not included, Only Perfusion in Plaque Area Rapid Clearance Injection Quantitative Monitoring of Plaque Perfusion
  36. 36. Average Enhancement: 115768 Rapid Clearance Injection Injection Intimo-Medial and Plaque Area Adventitia Area Quantitative Monitoring of Plaque Perfusion
  37. 37. Vasa Vasorum Imaging Clinical Trials Ongoing Stay Tuned!

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