SHAPE Society

3. Ritman et al.

5. Ritman et al.

6. Ritman et al.

7. Ritman et al.

8. Virmani et al.

10. Update on Image Analysis of
Ultimate IVUS Preliminary Case
Studies

11. Ultimate IVUS
Vasa Vasaorum
Image Analysis
CASE No 1

12. 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)

13. Dataset: 031204

16. 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

17. Dataset: 031204
IVUS Movie of Only Microbubble Enhanced Spots

18. Range of Enhancement

19. Differential Enhancement:
031204 Post-injection
(Frame #800)
Peak Injection
(Frame #600)
Ultimate IVUS Vasa Vasorum Imaging – Template 1

20. Differential Enhancement:
031204Peak Injection
(Frame #600)
Post-injection
(Frame #800)
Ultimate IVUS Vasa Vasorum Imaging – Template 2

21. Differential Enhancement:
031204 Post-injection
(Frame #800)
Peak Injection
(Frame #600)
Ultimate IVUS Vasa Vasorum Imaging – Template 3

22. Expected Correlation with the Anatomy of Vasa Vasorum
Note: Pathology pictures are not related to IVUS (Pathology taken from Ritman et al.)

23. Average Enhancement: 031204
Intimo-Medial and Plaque Area Adventitia Area
10 Frames per Second
Quantitative Monitoring of Plaque Perfusion

24. Average Enhancement: 031204
Intimo-Medial and Plaque Area Adventitia Area
Quantitative Monitoring of Plaque Perfusion

25. Ultimate IVUS
Image Analysis of
CASE No 2

26. 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

27. Dataset: 040116
Please wait for 30 sec!
Injection: Frames #1700-1800

28. Pre-injection
(Frame #388)
Peak Injection
(Frame #2837)
Post-injection
(Frame #5308)
Differential Enhancement:
040116
Real time Visualization

29. Differential Enhancement:
040116 Post InjectionPeak Injection
Ultimate IVUS Vasa Vasorum Imaging – Template 1

30. 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

31. Differential Enhancement:
040116 Post InjectionPeak Injection
Ultimate IVUS Vasa Vasorum Imaging– Template 3

32. 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

33. 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

34. Ultimate IVUS
Image Analysis of
CASE No 3

35. 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)

36. Dataset: 115768

37. Differential Enhancement:
115768
Pre-injection
(Frame #752, Loop 4)
After peak
(Frame #445, Loop 6)
Post-injection
(Frame #815, Loop 6)
Real time Visualization

38. Differential Enhancement:
115768After peak in lumen
(Frame #445, Loop 6)
Post-injection
(Frame #815, Loop 6)
Ultimate IVUS Vasa Vasorum Imaging– Template 1

39. Differential Enhancement:
115768Peak Injection
(Frame #445, Loop 6)
Post-injection
(Frame #815, Loop 6)
Ultimate IVUS Vasa Vasorum Imaging – Template 2

40. Differential Enhancement:
115768Peak Injection
(Frame #445, Loop 6)
Post-injection
(Frame #815, Loop 6)
Ultimate IVUS Vasa Vasorum Imaging– Template 3

41. Average Enhancement: 115768
Lumen Flow Not included,
Only Perfusion in Plaque Area
Rapid
Clearance
Injection
Quantitative Monitoring of Plaque Perfusion

42. Average Enhancement: 115768
Rapid
Clearance
Injection
Injection
Intimo-Medial and Plaque Area Adventitia Area
Quantitative Monitoring of Plaque Perfusion

43. Vasa Vasorum Imaging
Clinical Trials Ongoing
Stay Tuned!